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Individual

MR. JEROME A PRUSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
ZABLOCKI DEPARTMENT OF VETERAN AFFAIRS MEDICAL CTR, 500 WEST NATIONAL AVENUE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 389-4276
Mailing address
3116 N OAKDALE LN, APPLETON, WI 54914-6875
(920) 735-1605

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12132-040
WI
183500000X
Pharmacist
RP 033110 L
PA

Other

Enumeration date
07/26/2006
Last updated
07/08/2007
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