Provider Demographics
NPI:1528380540
Name:HUFF, MICHAEL RAY (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RAY
Last Name:HUFF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 HIGHWAY 169 N
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:IA
Mailing Address - Zip Code:50511-1003
Mailing Address - Country:US
Mailing Address - Phone:515-295-7704
Mailing Address - Fax:515-295-9341
Practice Address - Street 1:1501 HIGHWAY 169 N
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:IA
Practice Address - Zip Code:50511-1003
Practice Address - Country:US
Practice Address - Phone:515-295-7704
Practice Address - Fax:515-295-9341
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH15033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist