Provider Demographics
NPI:1689685182
Name:RANBURN DRUGS INC
Entity Type:Organization
Organization Name:RANBURN DRUGS INC
Other - Org Name:RANBURN DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-980-4898
Mailing Address - Street 1:24509 W LOCKPORT ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2318
Mailing Address - Country:US
Mailing Address - Phone:815-327-4835
Mailing Address - Fax:779-435-1360
Practice Address - Street 1:3977 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-2476
Practice Address - Country:US
Practice Address - Phone:219-980-4898
Practice Address - Fax:219-980-2997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IN60001334A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100298650Medicaid
2024866OtherPK
1174220001Medicare NSC