Provider Demographics
NPI:1063505402
Name:RAMON PHARMACY INC
Entity Type:Organization
Organization Name:RAMON PHARMACY INC
Other - Org Name:RAMON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-533-2232
Mailing Address - Street 1:6218 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-3431
Mailing Address - Country:US
Mailing Address - Phone:215-533-2233
Mailing Address - Fax:215-533-6607
Practice Address - Street 1:6218 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-3431
Practice Address - Country:US
Practice Address - Phone:215-533-2233
Practice Address - Fax:215-533-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336M0003X
PAPP411958L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000998079Medicaid
3903300OtherNCPDP PROVIDER IDENTIFICATION NUMBER