Provider Demographics
NPI:1629318373
Name:RUSHING, ROBERT LUTHER JR (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LUTHER
Last Name:RUSHING
Suffix:JR
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 1:5780 TERRY RD
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-9745
Mailing Address - Country:US
Mailing Address - Phone:601-346-2553
Mailing Address - Fax:
Practice Address - Street 1:5780 TERRY RD
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-9745
Practice Address - Country:US
Practice Address - Phone:601-346-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist