Provider Demographics
NPI:1790075992
Name:OOMMEN, RUBY
Entity Type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:
Last Name:OOMMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 JONES FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9297
Mailing Address - Country:US
Mailing Address - Phone:919-851-1418
Mailing Address - Fax:919-851-4928
Practice Address - Street 1:2711 JONES FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9297
Practice Address - Country:US
Practice Address - Phone:919-851-1418
Practice Address - Fax:919-851-4928
Is Sole Proprietor?:No
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist