MEDICARE: MR. JOHN RUONA RPH

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
1	183500000X	Pharmacist	11602040	WI

General Provider Information

NPI Number	:	1881603694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN RUONA RPH

Provider Business Mailing Address
First Line	:	1925 FIELD CLIFFE DR
Second Line	:
City	:	RICHFIELD
State	:	WI
Zip	:	53076
Country	:	US
Telephone Number	:	262-628-3305
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 N GREEN BAY RD
Second Line	:
City	:	BROWN DEER
State	:	WI
Zip	:	53209-1104
Country	:	US
Telephone Number	:	414-354-7213
Fax Number	:	414-354-7932

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	12/14/2015

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