DR. KEITH D RUBRUM (NPI# 1700161296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700161296 |
| Entity Type | Individual |
| Full Name | DR. KEITH D RUBRUM |
| Credential | DPH |
| Practice Address |
4155 Hwy 61 S Memphis TN 38109 |
| Mailing Address |
4155 Hwy 61 South Memphis TN 38109 |
| Practice Telephone | 9017851165 |
| Practice Fax Number | 9017851165 |
| Mailing Telephone | 9017851165 |
| Mailing Fax Number | 9017851165 |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2011-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5672 | TN | Pharmacy Service Providers |
| Street Address |
4155 HWY 61 S |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851937791 | Phyllis Person | Technician | 292 Modder Ave, Memphis, TN 38109 | 2019-11-26 |
| 1598233900 | Catherine Denise Baines | Technician | 697 Whitehave Lane, Memphis, TN 38109 | 2018-11-05 |
| 1821597808 | Patricia Ann Brookins | Occupational Therapy Assistant | 922 Leacrest Ave, Memphis, TN 38109 | 2018-02-06 |
| 1922371657 | Rhonda Boutte | Pharmacist | 4155 Highway 61 South, Memphis, TN 38109 | 2012-02-10 |
| 1255616736 | Kandace Diggins | Pharmacist | 4155 Highway 61 S, Memphis, TN 38109 | 2011-10-17 |
| 1487940011 | Count Own Transportion | Non-emergency Medical Transport (VAN) | 4093 Ponca St, Memphis, TN 38109 | 2011-06-22 |
| 1083876502 | Patrickgrapevine | Community/Behavioral Health | 1833 South Third Street, Memphis, TN 38109 | 2008-06-26 |
| 1790837797 | 2001 Vision Center | Optometrist | 1930 South Third St, Memphis, TN 38109 | 2007-01-18 |
| 1750499984 | Jeff A. Beekhuizen | Family Medicine | 3362 S. Third Street, Christ Community Health Services Inc, Memphis, TN 38109 | 2006-08-28 |
| 1851531164 | Mary Kathryn Vescovo | Nurse Practitioner | 3362 S. Third Street, Christ Community Health Service Inc, Memphis, TN 38109 | 2009-02-26 |
| Find all providers in zip 38109 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497366678 | Punam Patel | Pharmacist | 3075 Lamar Ave, Memphis, TN 38114-6440 | 2020-08-12 |
| 1891315370 | Janell Lennice C Jackson | Pharmacist | 3670 Riverdale Road, Memphis, TN 38115 | 2020-04-24 |
| 1952935322 | Madison Ann Williams | Pharmacist | 1680 Century Center Pkwy Ste 15, Memphis, TN 38134-8827 | 2020-02-25 |
| 1558900290 | Jiderechukwu Ugonna Anyigbo | Pharmacist | 232 Keel Ave, Memphis, TN 38107-3736 | 2019-12-28 |
| 1740823525 | Erica Danielle Washington | Pharmacist | 6025 Walnut Grove Rd Ste 108, Memphis, TN 38120-2116 | 2019-10-23 |
| 1356983308 | Olivia Brooks Wingate | Pharmacist | 8700 W Trail Lake Dr Ste 205, Memphis, TN 38125-8205 | 2019-10-11 |
| 1891266201 | Sara Smigielski | Pharmacist | 5219 Sequoia Ave, Memphis, TN 38120-1544 | 2018-12-10 |
| 1104393313 | Christine Ven Handy | Pharmacist | 4667 Flamingo Rd, Memphis, TN 38117-6111 | 2018-10-25 |
| 1821595026 | Alan Carter | Pharmacist | 5293 Elvis Presley Blvd, Memphis, TN 38116-8233 | 2018-04-12 |
| 1104364728 | Heather Mullins | Pharmacist | 6949 Appling Farms Pkwy Ste 109, Memphis, TN 38133-4731 | 2017-02-02 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.