Individual provider Active NPI

Ruben Consolacion Balbastro, RPH

  • Pharmacist
  • Winston Salem, NC
National Provider Identifier
1710208723
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18538 Issued in NC
Practice address
3440 Robinhood Rd
Winston Salem, NC 27106-4702
Phone
(336) 768-6610
NPI assigned
Jun 14, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18538 NC Primary

Addresses

Primary practice location

3440 Robinhood Rd
Winston Salem, NC 27106-4702

Mailing address

3033 Cameron Village CT
Winston Salem, NC 27103-3044
Phone (336) 768-6610

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

State licenses

LicenseStateTypeSpecialty
18538NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1710208723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 CAMERON VILLAGE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033044",
            "telephone_number": "336-768-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 ROBINHOOD RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064702",
            "telephone_number": "336-768-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBASTRO",
        "first_name": "RUBEN",
        "middle_name": "CONSOLACION",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "18538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.