Healthcare Provider Details

I. General information

NPI: 1396600987
Provider Name (Legal Business Name): ETHAN HUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PLATEAU OAKS DR
OAK HILL WV
25901-2262
US

IV. Provider business mailing address

107 1/2 BERRY ST
OAK HILL WV
25901-2742
US

V. Phone/Fax

Practice location:
  • Phone: 304-663-9537
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: