Provider Demographics
NPI:1376588806
Name:HOBBS PHARMACY UNITED INCORPORATED
Entity Type:Organization
Organization Name:HOBBS PHARMACY UNITED INCORPORATED
Other - Org Name:HOBBS NURSING HOME PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-452-5058
Mailing Address - Street 1:135 N BANANA RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-2546
Mailing Address - Country:US
Mailing Address - Phone:321-452-5058
Mailing Address - Fax:321-576-0529
Practice Address - Street 1:135 N BANANA RIVER DR
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-2546
Practice Address - Country:US
Practice Address - Phone:321-452-5058
Practice Address - Fax:321-576-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH112243336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2004342OtherPK
FL100100100Medicaid