MEDICARE: MRS. DANYEL BRUSKI 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	5302030242	MI

General Provider Information

NPI Number	:	1952686156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANYEL BRUSKI RPH

Provider Business Mailing Address
First Line	:	363 FREMONT ST STE 111
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49017-3395
Country	:	US
Telephone Number	:	692-245-8646
Fax Number	:	269-245-8648

Provider Business Practice Location Address
First Line	:	363 FREMONT ST STE 111
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49017-3395
Country	:	US
Telephone Number	:	269-245-8646
Fax Number	:	269-245-8648

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

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	01/06/2021

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