Provider Demographics
NPI:1497897334
Name:PAUL J RUWE INC
Entity Type:Organization
Organization Name:PAUL J RUWE INC
Other - Org Name:RUWE FAMILY PHARMACY BELLEVUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,AO
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:859-291-8665
Mailing Address - Street 1:103 LANDMARK DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1393
Mailing Address - Country:US
Mailing Address - Phone:859-291-8665
Mailing Address - Fax:859-291-2308
Practice Address - Street 1:103 LANDMARK DR
Practice Address - Street 2:SUITE 140
Practice Address - City:BELLEVUE
Practice Address - State:KY
Practice Address - Zip Code:41073-1393
Practice Address - Country:US
Practice Address - Phone:859-291-8665
Practice Address - Fax:859-291-2308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP060963336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2031909OtherPK
KY54030150Medicaid
KY90230194Medicaid
KY90230194Medicaid
2031909OtherPK
P00414050Medicare PIN