Provider Demographics
NPI:1639329816
Name:RBF LLC
Entity Type:Organization
Organization Name:RBF LLC
Other - Org Name:RAINBOW FOODS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-231-5000
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:MS2870
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-0473
Mailing Address - Country:US
Mailing Address - Phone:414-231-6153
Mailing Address - Fax:414-231-5500
Practice Address - Street 1:1201 LARPENTEUR AVE W
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-6318
Practice Address - Country:US
Practice Address - Phone:651-489-8620
Practice Address - Fax:651-489-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2637133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2117172OtherPK
MN654488100Medicaid
5305690022Medicare NSC