Healthcare Provider Details

I. General information

NPI: 1740401678
Provider Name (Legal Business Name): HUFF PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 MAIN ST
LEAKESVILLE MS
39451-6502
US

IV. Provider business mailing address

405 MAIN ST PO BOX 100
LEAKESVILLE MS
39451-6502
US

V. Phone/Fax

Practice location:
  • Phone: 601-394-2901
  • Fax: 601-394-5568
Mailing address:
  • Phone: 601-394-2901
  • Fax: 601-394-5568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberE6228
License Number StateMS

VIII. Authorized Official

Name: MR. JAMES DAVID HUFF
Title or Position: PHARMACIST
Credential: RPH
Phone: 601-394-2901