Healthcare Provider Details

I. General information

NPI: 1043882178
Provider Name (Legal Business Name): BILLY CHARLES HUFF III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 NASHVILLE PIKE
GALLATIN TN
37066-3123
US

IV. Provider business mailing address

523 FIVE OAKS BLVD
LEBANON TN
37087-1350
US

V. Phone/Fax

Practice location:
  • Phone: 615-451-4139
  • Fax:
Mailing address:
  • Phone: 615-636-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45356
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: