Provider Demographics
NPI:1467069039
Name:HUBBS, GARRETT THOMAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:THOMAS
Last Name:HUBBS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3752 W DEER CIRCLE BLVD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:IN
Mailing Address - Zip Code:47243-8991
Mailing Address - Country:US
Mailing Address - Phone:812-599-8573
Mailing Address - Fax:
Practice Address - Street 1:1600 E TIPTON ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-3560
Practice Address - Country:US
Practice Address - Phone:812-522-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY021531183500000X
IN26028917A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist