Provider Demographics
NPI:1427411313
Name:PAUL J RUWE INC
Entity Type:Organization
Organization Name:PAUL J RUWE INC
Other - Org Name:RUWE FAMILY PHARMACY COVINGTON LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-431-3304
Mailing Address - Street 1:434 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2342
Mailing Address - Country:US
Mailing Address - Phone:859-431-3304
Mailing Address - Fax:859-431-3305
Practice Address - Street 1:434 SCOTT ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2342
Practice Address - Country:US
Practice Address - Phone:859-431-3304
Practice Address - Fax:859-431-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP016003336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54018452Medicaid
2159076OtherPK
KY7100046210Medicaid
1017370003Medicare NSC