Provider Demographics
NPI:1033425384
Name:RUGGLES, TAMARA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:RUGGLES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-2024
Mailing Address - Country:US
Mailing Address - Phone:701-220-8798
Mailing Address - Fax:
Practice Address - Street 1:303 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4020
Practice Address - Country:US
Practice Address - Phone:701-223-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist