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NPI Code Detail

MEDICARE: LISA PATTERSON HUBBARD PHARMD

MEDICARE: LISA PATTERSON HUBBARD PHARMD
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
1183500000XPharmacistP6091ID

General Provider Information

NPI Number : 1891572905
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA PATTERSON HUBBARD PHARMD
Provider Business Mailing Address
First Line : 3374 S PECOS DR
Second Line :
City : WASHINGTON
State : UT
Zip : 84780-3445
Country : US
Telephone Number : 208-871-3988
Fax Number :
Provider Business Practice Location Address
First Line : 2276 E RIVERSIDE DR
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84790-2636
Country : US
Telephone Number : 435-986-2565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2023
Last Update Date : 09/12/2023

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