Healthcare Provider Details

I. General information

NPI: 1437143021
Provider Name (Legal Business Name): RBK CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3202 OBERLIN AVE
LORAIN OH
44053-2752
US

IV. Provider business mailing address

3202 OBERLIN AVE
LORAIN OH
44053-2752
US

V. Phone/Fax

Practice location:
  • Phone: 440-282-4044
  • Fax: 440-282-6328
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: PRESIDENT
Credential:
Phone: 440-366-9670