Provider Demographics
NPI:1720379001
Name:RUFFINI, PHILIP GABLE (RPH)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:GABLE
Last Name:RUFFINI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 WOLF RUN RD SE
Mailing Address - Street 2:
Mailing Address - City:DENNISON
Mailing Address - State:OH
Mailing Address - Zip Code:44621-8921
Mailing Address - Country:US
Mailing Address - Phone:740-922-0883
Mailing Address - Fax:
Practice Address - Street 1:705 W HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2057
Practice Address - Country:US
Practice Address - Phone:330-339-2565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-11713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist