Provider Demographics
NPI:1720696974
Name:HIGHLANDER, HUNTER GAVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:GAVIN
Last Name:HIGHLANDER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 OLDE ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-7439
Mailing Address - Country:US
Mailing Address - Phone:304-940-0490
Mailing Address - Fax:
Practice Address - Street 1:106 21ST ST
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143-1740
Practice Address - Country:US
Practice Address - Phone:304-755-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0011736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist