Healthcare Provider Details

I. General information

NPI: 1073740635
Provider Name (Legal Business Name): RBF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5370 16TH AVE
ST LOUIS PARK MN
55416
US

IV. Provider business mailing address

PO BOX 473 MS2870
MILWAUKEE WI
53201-0473
US

V. Phone/Fax

Practice location:
  • Phone: 952-546-1951
  • Fax: 952-545-6715
Mailing address:
  • Phone: 414-231-6153
  • Fax: 414-231-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number263712
License Number StateMN

VIII. Authorized Official

Name: EDWARD KITZ
Title or Position: VP/SECRETARY/TREAS
Credential:
Phone: 414-231-5000