Provider Demographics
NPI:1326150525
Name:BRUNO, HENRY N JR (RPH,PD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:N
Last Name:BRUNO
Suffix:JR
Gender:M
Credentials:RPH,PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2304
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21922-2304
Mailing Address - Country:US
Mailing Address - Phone:610-420-9625
Mailing Address - Fax:
Practice Address - Street 1:723 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5309
Practice Address - Country:US
Practice Address - Phone:410-398-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist