Healthcare Provider Details

I. General information

NPI: 1518966456
Provider Name (Legal Business Name): HUFFMAN MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 HARRINGTON HWY
EDEN NC
27288-7550
US

IV. Provider business mailing address

PO BOX 1207
EDEN NC
27289-1207
US

V. Phone/Fax

Practice location:
  • Phone: 336-627-0750
  • Fax: 336-623-7160
Mailing address:
  • Phone: 336-627-0750
  • Fax: 336-623-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number00125
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number00125
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0206009062
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number0206009062
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0206009062
License Number StateVA
# 6
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number00125
License Number StateNC

VIII. Authorized Official

Name: KEVIN STUART HUFFMAN
Title or Position: VICE PRESIDENT / OWNER
Credential:
Phone: 336-627-0750