MEDICARE: MR. CURTIS JAMES RUDE PHARM.D.

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	03-3-18738	OH

General Provider Information

NPI Number	:	1780756452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CURTIS JAMES RUDE PHARM.D.

Provider Business Mailing Address
First Line	:	3235 BRADY LAKE RD
Second Line	:
City	:	RAVENNA
State	:	OH
Zip	:	44266-1745
Country	:	US
Telephone Number	:	330-296-4681
Fax Number	:

Provider Business Practice Location Address
First Line	:	3235 BRADY LAKE RD
Second Line	:
City	:	RAVENNA
State	:	OH
Zip	:	44266-1745
Country	:	US
Telephone Number	:	330-296-4681
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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