Healthcare Provider Details

I. General information

NPI: 1528058450
Provider Name (Legal Business Name): BARRY MICHAEL KUBAS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/22/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 8TH ST
NEW KENSINGTON PA
15068-6201
US

IV. Provider business mailing address

508 8TH ST
NEW KENSINGTON PA
15068-6201
US

V. Phone/Fax

Practice location:
  • Phone: 724-337-3515
  • Fax: 724-337-3517
Mailing address:
  • Phone: 724-337-3515
  • Fax: 724-337-3517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP030699L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: