Provider Demographics
NPI:1003131236
Name:CARRUBA, VITO J (PHARMD)
Entity Type:Individual
Prefix:
First Name:VITO
Middle Name:J
Last Name:CARRUBA
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 1:3325 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4339
Mailing Address - Country:US
Mailing Address - Phone:205-556-3800
Mailing Address - Fax:205-556-0142
Practice Address - Street 1:3325 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-4339
Practice Address - Country:US
Practice Address - Phone:205-556-3800
Practice Address - Fax:205-556-0142
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist