Riendeau, Bruce Jon

Riendeau, Bruce Jon is an sole proprietor health care provider with primary practice located at N2585 Plaza Rd # 1409 , Wautoma WI 54982-7706. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Riendeau, Bruce Jon can be contacted via phone (920) 787-2090.

Contact Information

Primary practice address
N2585 Plaza Rd # 1409 Wautoma WI 54982-7706
Fax: (920) 787-4605
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 13298-40 Wisconsin

Profile Details

NPI number 1821342627
LBN Legal business name Riendeau, Bruce Jon
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2012
Last updated Oct 31st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821342627 NPPES
Wisconsin MEDICAID 1811941586

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