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RUBICON DTP LLC NPI 1174091557


NPI Information

NPI: 1174091557
Provider Name: RUBICON DTP, LLC

Doing Business As: RUBICON RX

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
5751 W 73RD ST # A
INDIANAPOLIS, IN
ZIP 46278
Phone: (317) 524-1515
Get Directions

RUBICON DTP, LLC is a pharmacy in Indianapolis, IN. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. RUBICON DTP, LLC NPI is 1174091557. The provider is registered as an organization entity type.
The provider Is Doing Business As Rubicon Rx.

The provider's business location address is:

5751 W 73RD ST # A
INDIANAPOLIS, IN
ZIP 46278-741
Phone: (317) 524-1515
Fax: (844) 325-7228

The provider's authorized official is David Burand .
The authorized official title is President- Pic and has the following contact phone number (317) 552-1100.

The enumeration date for this NPI number is 11/5/2018 and was last updated on 11/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336L0003XPharmacyLong Term Care PharmacyNo
23336M0002XPharmacyMail Order PharmacyNo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11569776OTHERNCPDP
21407877467OTHERNPI
320080595AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.