Healthcare Provider Details

I. General information

NPI: 1326332297
Provider Name (Legal Business Name): JOHN CHAPMAN RUGGLES PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 RAILROAD ST
ST JOHNSBURY VT
05819-1633
US

IV. Provider business mailing address

502 RAILROAD ST
ST JOHNSBURY VT
05819-1633
US

V. Phone/Fax

Practice location:
  • Phone: 802-748-5210
  • Fax:
Mailing address:
  • Phone: 802-748-5210
  • Fax: 802-748-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033-0002129
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: