Organization
RUSCH RX INC
Active
Other names
RUSCH'S SOUTHSIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS RUSCH (PRESIDENT/PHARMACIST)
(812) 316-0079
Entity
Organization
Contact information
Practice address
1107 S 15TH ST, VINCENNES, IN 47591-4223
(812) 316-0079
(812) 316-0510
Mailing address
1107 S 15TH ST, VINCENNES, IN 47591-4223
(812) 316-0079
(812) 316-0510
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006339A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201165910 A
—
IN
05
—
201165910A
—
IN
01
—
2140731
PK
—
Enumeration date
06/12/2013
Last updated
02/20/2017
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