Healthcare Provider Details

I. General information

NPI: 1841589454
Provider Name (Legal Business Name): STEVEN JEFFERY HUFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W MAIN ST LOUISVILLE
LOUISVILLE OH
44641-1335
US

IV. Provider business mailing address

590 OLDE ORCHARD DR NE
BOLIVAR OH
44612-8880
US

V. Phone/Fax

Practice location:
  • Phone: 330-875-1429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03316068
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: