MEDICARE: DR. BRADLEY RANDALL RUFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302034753	MI
2	183500000X	Pharmacist	PS43372	FL

General Provider Information

NPI Number	:	1467601450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY RANDALL RUFF

Provider Business Mailing Address
First Line	:	2120 E SALZBURG RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 E SALZBURG RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9737
Country	:	US
Telephone Number	:	989-301-0250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2008
Last Update Date	:	05/14/2014

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