Provider Demographics
NPI:1871166546
Name:RUTIG, JEFFREY L (BS, RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:L
Last Name:RUTIG
Suffix:
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 TYLER RD STE 1890
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6374
Mailing Address - Country:US
Mailing Address - Phone:540-639-1647
Mailing Address - Fax:540-639-0151
Practice Address - Street 1:2900 TYLER RD STE 1890
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6374
Practice Address - Country:US
Practice Address - Phone:540-639-1647
Practice Address - Fax:540-639-0151
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist