Provider Demographics
NPI:1205394673
Name:BRUCE ENTERPRISE LLC
Entity Type:Organization
Organization Name:BRUCE ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOUCH
Authorized Official - Middle Name:
Authorized Official - Last Name:UCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-463-8888
Mailing Address - Street 1:123 S COMMERCE ST STE A
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-2837
Mailing Address - Country:US
Mailing Address - Phone:209-463-5582
Mailing Address - Fax:209-490-4995
Practice Address - Street 1:123 S COMMERCE ST STE A
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2837
Practice Address - Country:US
Practice Address - Phone:209-463-5582
Practice Address - Fax:209-490-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy