Provider Demographics
NPI:1386758480
Name:LUBECKI, RICHARD J (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:LUBECKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-2100
Mailing Address - Country:US
Mailing Address - Phone:724-929-9487
Mailing Address - Fax:
Practice Address - Street 1:175 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2305
Practice Address - Country:US
Practice Address - Phone:724-258-4545
Practice Address - Fax:724-258-7909
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031843L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP031843LOtherSTATE LICENSE NUMBER