Healthcare Provider Details

I. General information

NPI: 1467731711
Provider Name (Legal Business Name): DEBORAH A HUFFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 W MAIN ST
BRIDGEPORT WV
26330-1657
US

IV. Provider business mailing address

175 WINDING SPRINGS DR
MORGANTOWN WV
26508-4021
US

V. Phone/Fax

Practice location:
  • Phone: 304-842-0647
  • Fax: 304-842-0658
Mailing address:
  • Phone: 304-864-3393
  • Fax: 304-842-0658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6758
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: