1982771747 NPI number — HERBERT CHARLES RUBRIGHT JR. MD

Table of content: HERBERT CHARLES RUBRIGHT JR. MD (NPI 1982771747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982771747 NPI number — HERBERT CHARLES RUBRIGHT JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUBRIGHT
Provider First Name:
HERBERT
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982771747
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
142 JAMES STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KASKA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17959-1253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-277-0329
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 UNIVERSITY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHUYLKILL HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17972-2212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-385-0331
Provider Business Practice Location Address Fax Number:
570-385-1007
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD022606E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QG0300X , with the licence number: MD022606E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01665101 . This is a "CAPITAL BLUE CROSS PROVID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 017308400 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0010656720007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02616500 . This is a "CAPITAL BLUE CROSS GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 080085836 . This is a "PALMETTO GBA MEDICARE RR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 159845 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 159845 . This is a "FEDERAL BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com