Individual provider Active NPI

Robert B Kubasak, R.PH.

  • Pharmacist
  • Elyria, OH
National Provider Identifier
1295729895
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03-3-10545 Issued in OH
Practice address
403 Cleveland St
Elyria, OH 44035-6143
Phone
(440) 366-9670
Fax
(440) 365-7891
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03-3-10545 OH Primary

Addresses

Primary practice location

403 Cleveland St
Elyria, OH 44035-6143

Mailing address

37580 Eagle Nest Dr
Grafton, OH 44044-9790
Phone (440) 366-9670

Other identifiers 1

IdentifierTypeStateIssuer
03-3-10545OtherOHPHARMACIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295729895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37580 EAGLE NEST DR",
            "city": "GRAFTON",
            "state": "OH",
            "postal_code": "440449790",
            "telephone_number": "440-366-9670",
            "fax_number": "440-365-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 CLEVELAND ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356143",
            "telephone_number": "440-366-9670",
            "fax_number": "440-365-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBASAK",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-3-10545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "03-3-10545",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.