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Organization
RUBICON DTP, LLC
Active
Organization
RUBICON DTP, LLC
Active
Other names
Rubicon Rx
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BURAND RPH (PRESIDENT- PIC)
(317) 552-1100
Entity
Organization
Contact information
Practice address
5751 W 73RD ST # A, INDIANAPOLIS, IN 46278-1741
(317) 524-1515
(844) 325-7228
Mailing address
5175 W 73RD STREET, B, INDIANAPOLIS, IN 46278
(833) 200-2010
(317) 552-1101
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407877467
NPI
—
01
—
1569776
NCPDP
—
05
—
20080595A
—
IN
Enumeration date
11/05/2018
Last updated
11/27/2023
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