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NPI Code Detail

MEDICARE: MRS. LOU ANN BRUCK R.PH

MEDICARE: MRS. LOU ANN BRUCK R.PH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPHS006972AZ

General Provider Information

NPI Number : 1043623176
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LOU ANN BRUCK R.PH
Provider Business Mailing Address
First Line : 240 APPALOOSA DR
Second Line :
City : SEDONA
State : AZ
Zip : 86351-9382
Country : US
Telephone Number : 808-430-6337
Fax Number :
Provider Business Practice Location Address
First Line : 1995 W HWY 89A
Second Line :
City : SEDONA
State : AZ
Zip : 86336-5531
Country : US
Telephone Number : 928-282-3903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 06/05/2014

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Directions to “ MRS. LOU ANN BRUCK R.PH” Practice Location

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