MEDICARE: MS. RHODA ELMORE HUFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor		GA

General Provider Information

NPI Number	:	1093369787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RHODA ELMORE HUFF

Provider Business Mailing Address
First Line	:	1206 WESTWOOD DR APT A
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-7326
Country	:	US
Telephone Number	:	229-343-7569
Fax Number	:

Provider Business Practice Location Address
First Line	:	1206 WESTWOOD DR APT A
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-7326
Country	:	US
Telephone Number	:	229-343-7569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2019
Last Update Date	:	07/31/2019

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