Provider Demographics
NPI:1679846448
Name:RINCHUSO, ALBERT ANTHONY (RPH)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:ANTHONY
Last Name:RINCHUSO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:ALBERT
Other - Middle Name:
Other - Last Name:RINCHUSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2719 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4584
Mailing Address - Country:US
Mailing Address - Phone:501-680-1079
Mailing Address - Fax:
Practice Address - Street 1:2719 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4584
Practice Address - Country:US
Practice Address - Phone:501-680-1079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07293183500000X
TX50979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist