MEDICARE: RBF LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	262624	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2048589	OTHER		PK

General Provider Information

NPI Number	:	1275681538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RBF LLC

Provider Business Mailing Address
First Line	:	PO BOX 473
Second Line	:	MS 2870
City	:	MILWAUKEE
State	:	WI
Zip	:	53201-0473
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17756 KENWOOD TRL
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-9454
Country	:	US
Telephone Number	:	952-898-4505
Fax Number	:	952-898-6361

Authorized Official
Title or Position	:	GVP - LEGAL RISK & TREASURY
Name	:	EDWARD KITZ
Credential	:
Telephone Number	:	414-231-5904

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	03/25/2014

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