Provider Demographics
NPI:1134008444
Name:ABRAHAM, RUBEN AGEES (PHARMD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:AGEES
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 STAGECOACH DR UNIT 2110
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-3903
Mailing Address - Country:US
Mailing Address - Phone:630-418-6076
Mailing Address - Fax:
Practice Address - Street 1:104 E 1ST ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-1703
Practice Address - Country:US
Practice Address - Phone:515-963-7889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist