Healthcare Provider Details

I. General information

NPI: 1366511602
Provider Name (Legal Business Name): HOBBS PHARMACY UNITED INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 N BANANA RIVER DR
MERRITT ISLAND FL
32952-2546
US

IV. Provider business mailing address

133 N BANANA RIVER DR
MERRITT ISLAND FL
32952-2546
US

V. Phone/Fax

Practice location:
  • Phone: 321-452-0010
  • Fax: 321-452-6716
Mailing address:
  • Phone: 321-452-0010
  • Fax: 321-452-6716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH0000743
License Number StateFL

VIII. Authorized Official

Name: SIDNEY HOBBS
Title or Position: OWNER
Credential:
Phone: 321-452-0010