Provider Demographics
NPI:1952683104
Name:RUFFIN, CRAIG (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:RUFFIN
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 GLENDEVON DR
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-1859
Mailing Address - Country:US
Mailing Address - Phone:215-353-3199
Mailing Address - Fax:215-591-0771
Practice Address - Street 1:1018 GLENDEVON DR
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-1859
Practice Address - Country:US
Practice Address - Phone:215-353-3199
Practice Address - Fax:215-591-0771
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28 RI 01836500183500000X
DCPH 100000660183500000X
DEA1-0003976183500000X
MD19291183500000X
MI5302039290183500000X
PARP4430941835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear
No183500000XPharmacy Service ProvidersPharmacist