Provider Demographics
NPI:1518249077
Name:HUBBARD, ROBERT C III (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:HUBBARD
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522-2208
Mailing Address - Country:US
Mailing Address - Phone:434-352-5292
Mailing Address - Fax:775-213-9749
Practice Address - Street 1:2004 WARDS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5310
Practice Address - Country:US
Practice Address - Phone:434-832-0935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202-011401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist