Provider Demographics
NPI:1720385701
Name:RUBINO, LOUIS M (RPH)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:M
Last Name:RUBINO
Suffix:
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 1:220 CLAREMONT AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-4434
Mailing Address - Country:US
Mailing Address - Phone:570-668-1900
Mailing Address - Fax:570-668-8812
Practice Address - Street 1:220 CLAREMONT AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-4434
Practice Address - Country:US
Practice Address - Phone:570-668-1900
Practice Address - Fax:570-668-8812
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034837L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist