Provider Demographics
NPI:1245302033
Name:LEPRI-RUANE INC
Entity type:Organization
Organization Name:LEPRI-RUANE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUANE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:570-347-6575
Mailing Address - Street 1:2239 PITTSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-3237
Mailing Address - Country:US
Mailing Address - Phone:570-347-6575
Mailing Address - Fax:570-963-7109
Practice Address - Street 1:2239 PITTSTON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-3237
Practice Address - Country:US
Practice Address - Phone:570-347-6575
Practice Address - Fax:570-963-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413974L333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3954662OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA0011026960001Medicaid
PA0011026960001Medicaid
PA0011026960001Medicaid