Provider Demographics
NPI:1730431487
Name:XUBEX COMMUNITY PHARMACY INC
Entity type:Organization
Organization Name:XUBEX COMMUNITY PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-331-2030
Mailing Address - Street 1:500 S.R. 436
Mailing Address - Street 2:SUITE 1010
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707
Mailing Address - Country:US
Mailing Address - Phone:407-624-5088
Mailing Address - Fax:407-767-7770
Practice Address - Street 1:500 STATE ROAD 436 STE 1010
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5376
Practice Address - Country:US
Practice Address - Phone:407-624-5088
Practice Address - Fax:407-767-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-04
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X, 3336M0002X, 3336S0011X
FLPH265293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2137994OtherPK