Healthcare Provider Details

I. General information

NPI: 1831435825
Provider Name (Legal Business Name): FRANK RICHARD RUZICH R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14401 SHOREVIEW DR
BAXTER MN
56425-8472
US

IV. Provider business mailing address

14401 SHOREVIEW DR
BAXTER MN
56425-8472
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-7202
  • Fax:
Mailing address:
  • Phone: 218-829-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number114367
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH4218
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: