Provider Demographics
NPI:1972924421
Name:HUBIACK, THOMAS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HUBIACK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 WIMBLEDON LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1454
Mailing Address - Country:US
Mailing Address - Phone:570-814-8617
Mailing Address - Fax:
Practice Address - Street 1:4220 5TH STREET HWY
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1738
Practice Address - Country:US
Practice Address - Phone:610-921-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440188183500000X
CA63741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist