Provider Demographics
NPI:1891865275
Name:HUFFMAN, PENNY SUSAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:SUSAN
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-8959
Mailing Address - Country:US
Mailing Address - Phone:251-232-8897
Mailing Address - Fax:
Practice Address - Street 1:9082 MOFFETT RD
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5242
Practice Address - Country:US
Practice Address - Phone:251-649-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist