Healthcare Provider Details

I. General information

NPI: 1841698909
Provider Name (Legal Business Name): HOBGOOD PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 COUNTRY CLUB RD STE 150
LAKE CHARLES LA
70605-6079
US

IV. Provider business mailing address

2640 COUNTRY CLUB RD STE 150
LAKE CHARLES LA
70605-6079
US

V. Phone/Fax

Practice location:
  • Phone: 337-602-6024
  • Fax: 337-602-6028
Mailing address:
  • Phone: 337-602-6024
  • Fax: 337-602-6028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number7014
License Number StateLA

VIII. Authorized Official

Name: MR. KRISTOPHER CHAD HOBGOOD
Title or Position: OWNER/PHARMACIST
Credential: PHARMD
Phone: 225-803-5463