Healthcare Provider Details

I. General information

NPI: 1376691634
Provider Name (Legal Business Name): RBF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16401 COUNTY ROAD 30
MAPLE GROVE MN
55311-1209
US

IV. Provider business mailing address

PO BOX 473 MS 2870
MILWAUKEE WI
53201-0473
US

V. Phone/Fax

Practice location:
  • Phone: 763-416-1563
  • Fax: 763-416-2769
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2623168
License Number StateMN

VIII. Authorized Official

Name: EDWARD KITZ
Title or Position: GVP - LEGAL RISK & TREASURY
Credential:
Phone: 414-231-5000