Provider Demographics
NPI:1972891562
Name:CUBITA, PAUL S JR (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:CUBITA
Suffix:JR
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8225 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-9508
Mailing Address - Country:US
Mailing Address - Phone:843-726-3067
Mailing Address - Fax:
Practice Address - Street 1:8225 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-9508
Practice Address - Country:US
Practice Address - Phone:843-726-3067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2011-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist