Provider Demographics
NPI:1902092240
Name:KUBAS DRUG
Entity Type:Organization
Organization Name:KUBAS DRUG
Other - Org Name:KUBAS DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KUBAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:724-337-3515
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1182561Medicaid
PABT2133469OtherDEA #
PABT2133469OtherDEA #