Rukundo, Theo Blaise

Rukundo, Theo Blaise is an sole proprietor health care provider with primary practice located at 850 Harrison Ave Ste Bn27 , Boston MA 02118-4001. He recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist. Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist is his primary health care specialty. Rukundo, Theo Blaise can be contacted via phone (857) 247-8763.

Contact Information

Primary practice address
850 Harrison Ave Ste Bn27 Boston MA 02118-4001
Phone: (857) 247-8763
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PCT.0012736 Connecticut
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH240122 Massachusetts

Profile Details

NPI number 1215342209
LBN Legal business name Rukundo, Theo Blaise
Credentials PHARMD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2014
Last updated Feb 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215342209 NPPES
Connecticut Other PCT.0012736 CONNECTICUT PHARMACIST LICENSE
Connecticut Other PH240122 CONNECTICUT PHARMACIST LICENSE

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