MEDICARE: HOBBS PHARMACY UNITED INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy	PH11224	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2004342	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376588806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOBBS PHARMACY UNITED INCORPORATED

Provider Business Mailing Address
First Line	:	135 N BANANA RIVER DR
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32952-2546
Country	:	US
Telephone Number	:	321-452-5058
Fax Number	:	321-576-0529

Provider Business Practice Location Address
First Line	:	135 N BANANA RIVER DR
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32952-2546
Country	:	US
Telephone Number	:	321-452-5058
Fax Number	:	321-576-0529

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SIDNEY HOBBS
Credential	:
Telephone Number	:	321-452-5058

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	03/01/2017

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