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NPI Code Detail

MEDICARE: MR. NICK G BRUCK PHARM-D

MEDICARE: MR. NICK G BRUCK PHARM-D
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
1183500000XPharmacistP6216ID
2183500000XPharmacist051-292929IL
3183500000XPharmacist6769MT
4183500000XPharmacistPH00055761WA

General Provider Information

NPI Number : 1679854251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NICK G BRUCK PHARM-D
Provider Business Mailing Address
First Line : 3511 W GARLAND AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99205-2122
Country : US
Telephone Number : 509-220-3398
Fax Number :
Provider Business Practice Location Address
First Line : 10220 N NEVADA ST STE 270
Second Line :
City : SPOKANE
State : WA
Zip : 99218-3124
Country : US
Telephone Number : 509-465-4775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 09/08/2011

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Directions to “ MR. NICK G BRUCK PHARM-D” Practice Location

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