Provider Demographics
NPI:1073873063
Name:KOEHLER, RONALD B (RPH, MBA)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:B
Last Name:KOEHLER
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W FRYE RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4950
Mailing Address - Country:US
Mailing Address - Phone:888-694-7287
Mailing Address - Fax:
Practice Address - Street 1:2700 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4950
Practice Address - Country:US
Practice Address - Phone:888-694-7287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHMOP022003750183500000X
KY012940183500000X
AZS016837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist