Provider Demographics
NPI:1154702900
Name:HUNTS MILL PHARMACY INC
Entity type:Organization
Organization Name:HUNTS MILL PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-323-2020
Mailing Address - Street 1:14 MAIN ST FL 1
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1328
Mailing Address - Country:US
Mailing Address - Phone:855-612-1387
Mailing Address - Fax:855-612-1388
Practice Address - Street 1:14 MAIN ST FL 1
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:855-612-1387
Practice Address - Fax:855-612-1388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
NJ28RS007417003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0597007Medicaid
2152556OtherPK