MEDICARE: DR. SARA J HUBBARD PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	25268	TN

General Provider Information

NPI Number	:	1306824529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA J HUBBARD PHARMD

Provider Business Mailing Address
First Line	:	920 ASHBROOKE WAY
Second Line	:	#1134
City	:	KNOXVILLE
State	:	TN
Zip	:	37923
Country	:	US
Telephone Number	:	865-769-0432
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 W CLINCH AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-2307
Country	:	US
Telephone Number	:	865-541-3698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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