Provider Demographics
NPI:1962850552
Name:RUBENS RX LLC
Entity Type:Organization
Organization Name:RUBENS RX LLC
Other - Org Name:RUBEN'S PHARMACY COMPOUNDING & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-639-5208
Mailing Address - Street 1:PO BOX 4494
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-4494
Mailing Address - Country:US
Mailing Address - Phone:956-639-5208
Mailing Address - Fax:956-800-1050
Practice Address - Street 1:615 E UNIVERSITY DR STE 1
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3635
Practice Address - Country:US
Practice Address - Phone:956-639-5208
Practice Address - Fax:956-800-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2164670OtherPK