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General NPI Number Information
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NPI Number | 1083727630
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Entity Type | Organization
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Legal Business Name | HUBBARD YOUNG PHARMACY INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 402 COLLEGE AVE
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City | CLEMSON
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State | SC
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Zip | 29631-2923
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Country | US
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Telephone | 864-654-1771
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Fax | 864-654-1772
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Provider Business Mailing Address
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Address Line | 402 COLLEGE AVE
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City | CLEMSON
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State | SC
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Zip | 29631-2923
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Country | US
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Telephone | 864-654-1771
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Fax | 864-654-1772
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS H TEASLEY
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Credential | PHARMD
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Telephone | 864-654-1771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50004274
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License Number State | SC
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