MEDICARE: JACOB RUFF PHARMD

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	183500000X	Pharmacist	03442236	OH

General Provider Information

NPI Number	:	1962125229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB RUFF PHARMD

Provider Business Mailing Address
First Line	:	6943 WESTIN RDG
Second Line	:
City	:	CLEVES
State	:	OH
Zip	:	45002-9416
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5811 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-6411
Country	:	US
Telephone Number	:	513-741-8870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2022
Last Update Date	:	09/22/2022

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