Provider Demographics
NPI:1477175479
Name:HUBBARD HEALTH CLINIC
Entity Type:Organization
Organization Name:HUBBARD HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:540-230-5375
Mailing Address - Street 1:804 WADSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-2920
Mailing Address - Country:US
Mailing Address - Phone:540-230-5375
Mailing Address - Fax:
Practice Address - Street 1:76 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-5014
Practice Address - Country:US
Practice Address - Phone:540-509-5018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care