Provider Demographics
NPI:1083796072
Name:HUBBARD, BRENDA G (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:G
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USHC GRAFENWOEHR
Mailing Address - Street 2:CMR 415, UNIT 28130
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09114
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USHC GRAFENWOEHR
Practice Address - Street 2:CMR 415, UNIT 28130
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09114
Practice Address - Country:DE
Practice Address - Phone:314-590-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist