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General NPI Number Information
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NPI Number | 1881603694
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Entity Type | Individual
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Provider Name | JOHN RUONA RPH
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 9200 N GREEN BAY RD
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City | BROWN DEER
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State | WI
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Zip | 53209-1104
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Country | US
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Telephone | 414-354-7213
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Fax | 414-354-7932
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Provider Business Mailing Address
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Address Line | 1925 FIELD CLIFFE DR
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City | RICHFIELD
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State | WI
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Zip | 53076
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Country | US
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Telephone | 262-628-3305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11602040
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License Number State | WI
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