Healthcare Provider Details

I. General information

NPI: 1164637567
Provider Name (Legal Business Name): HUFF PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E. WATER STREET
BOYNE CITY MI
49712-1242
US

IV. Provider business mailing address

121 E. WATER STREET
BOYNE CITY MI
49712-1242
US

V. Phone/Fax

Practice location:
  • Phone: 231-582-6515
  • Fax: 231-582-5008
Mailing address:
  • Phone: 231-582-6515
  • Fax: 231-582-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301002182
License Number StateMI

VIII. Authorized Official

Name: MR. ROBERT LEE HUFF
Title or Position: PRESIDENT
Credential: RPH
Phone: 231-582-6514