Provider Demographics
NPI:1073863312
Name:XUBEX PHARMACY LLC
Entity Type:Organization
Organization Name:XUBEX PHARMACY LLC
Other - Org Name:XUBEX PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-331-2030
Mailing Address - Street 1:500 SR 436 STE 2064
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5392
Mailing Address - Country:US
Mailing Address - Phone:407-378-2309
Mailing Address - Fax:866-495-3304
Practice Address - Street 1:500 STATE ROAD 436 STE 2064
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5392
Practice Address - Country:US
Practice Address - Phone:407-378-2309
Practice Address - Fax:866-495-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336M0002X, 3336S0011X
FLPH263243336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5711824OtherNCPDP PROVIDER IDENTIFICATION NUMBER