Provider Demographics
NPI:1356649404
Name:TRUBITS, PAUL ALBERT (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ALBERT
Last Name:TRUBITS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36729 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19967-6952
Mailing Address - Country:US
Mailing Address - Phone:302-539-3334
Mailing Address - Fax:
Practice Address - Street 1:36729 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6952
Practice Address - Country:US
Practice Address - Phone:302-539-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003408183500000X
MD09297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist