Healthcare Provider Details

I. General information

NPI: 1235538315
Provider Name (Legal Business Name): KAMERON HUFFMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 MALL BLVD STE 100
SAVANNAH GA
31406-4700
US

IV. Provider business mailing address

318 MALL BLVD STE 100
SAVANNAH GA
31406-4700
US

V. Phone/Fax

Practice location:
  • Phone: 912-200-9165
  • Fax:
Mailing address:
  • Phone: 912-200-9165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH027487
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH35718
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: