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General NPI Number Information
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NPI Number | 1376671636
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Entity Type | Organization
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Legal Business Name | JOSEPH C RUSKIN ENTERPRISES INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 2504 E PIKES PEAK AVE STE 106
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-7039
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Country | US
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Telephone | 719-447-9900
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Fax | 719-447-9922
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Provider Business Mailing Address
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Address Line | 2504 E PIKES PEAK AVE STE 106
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-7039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | KIMBERLY TREAT
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Credential | INTERN
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Telephone | 719-447-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 612
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License Number State | CO
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