Healthcare Provider Details

I. General information

NPI: 1952686156
Provider Name (Legal Business Name): DANYEL BRUSKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 01/06/2021
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 FREMONT ST STE 111
BATTLE CREEK MI
49017-3395
US

IV. Provider business mailing address

363 FREMONT ST STE 111
BATTLE CREEK MI
49017-3395
US

V. Phone/Fax

Practice location:
  • Phone: 269-245-8646
  • Fax: 269-245-8648
Mailing address:
  • Phone: 692-245-8646
  • Fax: 269-245-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302030242
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: