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NPI Code Detail

MEDICARE: DR. TARA DENISE LUBA PHARMD.

MEDICARE: DR. TARA DENISE LUBA 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
1183500000XPharmacist12279SC
21835P1200XPharmacotherapy Pharmacist12279SC

General Provider Information

NPI Number : 1487806303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARA DENISE LUBA PHARMD.
Provider Business Mailing Address
First Line : 1101 MAIN ST
Second Line :
City : HILTON HEAD
State : SC
Zip : 29926-1624
Country : US
Telephone Number : 843-681-2622
Fax Number : 843-681-9392
Provider Business Practice Location Address
First Line : 1101 MAIN ST
Second Line :
City : HILTON HEAD
State : SC
Zip : 29926-1624
Country : US
Telephone Number : 843-681-2622
Fax Number : 843-681-9392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2008
Last Update Date : 10/22/2008

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Directions to “ DR. TARA DENISE LUBA PHARMD.” Practice Location

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