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
Phone: (920) 787-2090
Fax: (920) 787-4605
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821342627 | NPPES |
| Wisconsin | MEDICAID | 1811941586 |
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