Healthcare Provider Details

I. General information

NPI: 1720859382
Provider Name (Legal Business Name): JOEL BERNARD HUFFMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4976
US

IV. Provider business mailing address

6119 E BROOKVIEW ST
WICHITA KS
67220-4417
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2000
  • Fax:
Mailing address:
  • Phone: 904-495-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-103823
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: