Healthcare Provider Details

I. General information

NPI: 1982147468
Provider Name (Legal Business Name): HOBBS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W BROADWAY AVE
SULPHUR OK
73086-4622
US

IV. Provider business mailing address

420 WEST BROADWAY
SULPHUR OK
73086
US

V. Phone/Fax

Practice location:
  • Phone: 580-622-3131
  • Fax: 580-622-4578
Mailing address:
  • Phone: 580-622-3131
  • Fax: 580-622-4578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number55-7607
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RUSSELL HOBBS
Title or Position: OWNER
Credential:
Phone: 580-622-3131