Provider Demographics
NPI:1437234556
Name:RPB PHARMACY, INC.
Entity Type:Organization
Organization Name:RPB PHARMACY, INC.
Other - Org Name:PHARMAHEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:508-998-8000
Mailing Address - Street 1:132 ALDEN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4721
Mailing Address - Country:US
Mailing Address - Phone:508-998-8000
Mailing Address - Fax:508-998-1145
Practice Address - Street 1:458 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1115
Practice Address - Country:US
Practice Address - Phone:508-996-3778
Practice Address - Fax:508-996-3779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RPB PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-26
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3056332B00000X, 3336C0003X, 3336C0004X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0409243Medicaid
MA0409243Medicaid