Active NPI
Bryan Hubbard, PHARMD.
- Pharmacist
- East Prairie, MO
National Provider Identifier
1285262519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2019030655
- Practice address
- 117 E Main St
East Prairie, MO 63845-1136 - Phone
- (573) 649-9229
- NPI assigned
- Mar 31, 2020
- Last updated
- Mar 31, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2019030655 | MO | Primary |
Addresses
Primary practice location
117 E Main St
East Prairie, MO 63845-1136
Mailing address
117 E Main St
East Prairie, MO 63845-1136
Phone (573) 649-9229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019030655 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Street RX, LLC | Current | Accepting new patients | |
| Main Street RX | Current | Accepting new patients |
Locations
117 E Main St
East Prairie, MO 63845
Phone (573) 649-9229
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Main Street Pharmacy LTC
- Long Term Care Pharmacy
- East Prairie, MO
- NPI 1164284634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1285262519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 E MAIN ST",
"city": "EAST PRAIRIE",
"state": "MO",
"postal_code": "638451136",
"telephone_number": "573-649-9229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 E MAIN ST",
"city": "EAST PRAIRIE",
"state": "MO",
"postal_code": "638451136",
"telephone_number": "573-649-9229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "BRYAN",
"credential": "PHARMD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2019030655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Prairie, MO
- Bethany Ferrell
- Claire E Grisham, FNP
- Rebecca Camille Hatton, COTA/L
- Jimmy D. Heath Jr., M.D.
- Patricia Hogan, RPH
- Main Street Pharmacy LLC (Main Street Pharmacy)
- Main Street Pharmacy LLC.
- Main Street RX (Main Street Pharmacy)
- Main Street RX, LLC (Main Street Pharmacy LTC)
- Susan Myrick Marshall, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.