Healthcare Provider Details

I. General information

NPI: 1083249312
Provider Name (Legal Business Name): HOBBS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W BROADWAY AVE
SULPHUR OK
73086-4622
US

IV. Provider business mailing address

420 W BROADWAY AVE
SULPHUR OK
73086-4622
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. RUSSELL SCOTT HOBBS
Title or Position: OWNER
Credential: PHARMD
Phone: 580-622-3131