Provider Demographics
NPI:1467744508
Name:HOBBS, MARY GRACE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:GRACE
Last Name:HOBBS
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 1:3116 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4204
Mailing Address - Country:US
Mailing Address - Phone:252-830-1027
Mailing Address - Fax:252-830-0393
Practice Address - Street 1:3116 E 10TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4204
Practice Address - Country:US
Practice Address - Phone:252-830-1027
Practice Address - Fax:252-830-0393
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist