Provider Demographics
NPI:1528058450
Name:KUBAS, BARRY MICHAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:MICHAEL
Last Name:KUBAS
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 1:508 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6201
Mailing Address - Country:US
Mailing Address - Phone:724-337-3515
Mailing Address - Fax:724-337-3517
Practice Address - Street 1:508 8TH ST
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6201
Practice Address - Country:US
Practice Address - Phone:724-337-3515
Practice Address - Fax:724-337-3517
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030699L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3959422OtherNABP
PA65362245OtherPA TAX NUMBER
PAPP41426LOtherPHARMACY PERMIT
PA0011825610001Medicaid
PA0011825610001Medicaid
PA65362245OtherPA TAX NUMBER