Provider Demographics
NPI:1831435825
Name:RUZICH, FRANK RICHARD (RPH)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:RICHARD
Last Name:RUZICH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14401 SHOREVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8472
Mailing Address - Country:US
Mailing Address - Phone:218-829-7202
Mailing Address - Fax:
Practice Address - Street 1:14401 SHOREVIEW DR
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8472
Practice Address - Country:US
Practice Address - Phone:218-829-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114367183500000X
NDRPH4218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist