Provider Demographics
NPI:1740893866
Name:HUBBARD, DANIELLE (RPH)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HUBBARD
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 1:1732 YOUNGSTOWN RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4254
Mailing Address - Country:US
Mailing Address - Phone:330-369-8434
Mailing Address - Fax:330-369-8443
Practice Address - Street 1:1732 YOUNGSTOWN RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4254
Practice Address - Country:US
Practice Address - Phone:330-369-8434
Practice Address - Fax:330-369-8443
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03221414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist