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General NPI Number Information
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NPI Number | 1962097584
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Entity Type | Individual
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Provider Name | BRENNA RUHNKE
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Gender | Female
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 6 MILLBROOK PLZ
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City | MILL HALL
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State | PA
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Zip | 17751-1911
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Country | US
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Telephone | 570-748-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 68 CAROL LN
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City | MALVERN
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State | PA
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Zip | 19355-2046
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Country | US
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Telephone | 610-350-6931
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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 | J9R5H3D3
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License Number State | PA
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