Provider Demographics
NPI:1750713673
Name:HUNTINGTON, MATTHEW DONALD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DONALD
Last Name:HUNTINGTON
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 1:10220 HAVEN ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4126
Mailing Address - Country:US
Mailing Address - Phone:520-991-1424
Mailing Address - Fax:
Practice Address - Street 1:770 S HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4639
Practice Address - Country:US
Practice Address - Phone:775-751-8399
Practice Address - Fax:775-751-8864
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18203183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist