Provider Demographics
NPI:1003139841
Name:RAMIREZ, JOSEPH M (RP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4613 BLUE JAY CT
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-9614
Mailing Address - Country:US
Mailing Address - Phone:308-635-2650
Mailing Address - Fax:308-631-7945
Practice Address - Street 1:802 E 27TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1754
Practice Address - Country:US
Practice Address - Phone:308-632-3822
Practice Address - Fax:308-632-5381
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8375183500000X
WY1875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist