MEDICARE: RB COMPOUNDING PHARMACY

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	3336C0003X	Community/Retail Pharmacy	PH22416	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1024075	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1841356110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RB COMPOUNDING PHARMACY

Provider Business Mailing Address
First Line	:	2311 SEVEN SPRINGS BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-3913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 SEVEN SPRINGS BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-3913
Country	:	US
Telephone Number	:	727-375-9500
Fax Number	:	727-375-9520

Authorized Official
Title or Position	:	OWNER
Name	:	BHRUGESH PATEL
Credential	:	MBA
Telephone Number	:	919-225-1092

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	08/22/2020

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