Provider Demographics
NPI:1811281694
Name:RUE, PEGGY (RPH)
Entity type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:
Last Name:RUE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BALSAM ST N
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-5814
Mailing Address - Country:US
Mailing Address - Phone:763-689-3687
Mailing Address - Fax:763-689-3687
Practice Address - Street 1:215 BALSAM ST N
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-5814
Practice Address - Country:US
Practice Address - Phone:763-689-3687
Practice Address - Fax:763-689-3687
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist