Nicole Ann Rubalcaba-Lopez, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

19263 Issued in CO

Practice address

78 N McCulloch Blvd
Pueblo West, CO 81007-4444

Phone

(719) 647-9925

NPI assigned

Dec 8, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1275801920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 N MCCULLOCH BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810074444",
            "telephone_number": "719-250-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 N MCCULLOCH BLVD",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810074444",
            "telephone_number": "719-647-9925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 W US Highway 50",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810081646",
            "country_code": "US",
            "telephone_number": "719-296-8007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBALCABA-LOPEZ",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "19263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Pharmacist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.