Provider Demographics
NPI:1477318780
Name:RAFUSE, ERIC B (RPH)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:B
Last Name:RAFUSE
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 1:16 NORTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1197
Mailing Address - Country:US
Mailing Address - Phone:484-678-7058
Mailing Address - Fax:
Practice Address - Street 1:1169 HORSESHOE PIKE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1367
Practice Address - Country:US
Practice Address - Phone:610-269-7368
Practice Address - Fax:610-269-2198
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-036777L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist