Provider Demographics
NPI:1235691767
Name:HUBBARD PHARMACY INC
Entity Type:Organization
Organization Name:HUBBARD PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMIRCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-639-0173
Mailing Address - Street 1:2012 GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-1625
Mailing Address - Country:US
Mailing Address - Phone:818-639-0173
Mailing Address - Fax:818-639-0183
Practice Address - Street 1:2012 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1625
Practice Address - Country:US
Practice Address - Phone:818-639-0173
Practice Address - Fax:818-639-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy