Healthcare Provider Details

I. General information

NPI: 1649263278
Provider Name (Legal Business Name): RBK CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 CLEVELAND ST
ELYRIA OH
44035-6143
US

IV. Provider business mailing address

403 CLEVELAND ST
ELYRIA OH
44035-6143
US

V. Phone/Fax

Practice location:
  • Phone: 440-366-9670
  • Fax: 440-365-7891
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 Number
License Number StateOH

VIII. Authorized Official

Name: ROBERT KUBASAK
Title or Position: PRES
Credential: RPH
Phone: 440-366-9670