Provider Demographics
NPI:1841698909
Name:HOBGOOD PHARMACY, LLC
Entity type:Organization
Organization Name:HOBGOOD PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:HOBGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:225-803-5463
Mailing Address - Street 1:2640 COUNTRY CLUB RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-6079
Mailing Address - Country:US
Mailing Address - Phone:337-602-6024
Mailing Address - Fax:337-602-6028
Practice Address - Street 1:2640 COUNTRY CLUB RD STE 150
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-6079
Practice Address - Country:US
Practice Address - Phone:337-602-6024
Practice Address - Fax:337-602-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA70143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy