Healthcare Provider Details

I. General information

NPI: 1083932776
Provider Name (Legal Business Name): BRUCE RANKINS R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 UNION AVE
LACONIA NH
03246-3115
US

IV. Provider business mailing address

288 UNION AVE
LACONIA NH
03246-3115
US

V. Phone/Fax

Practice location:
  • Phone: 603-528-1700
  • Fax: 603-528-5061
Mailing address:
  • Phone: 603-528-1700
  • Fax: 603-528-5061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1942
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: