Provider Demographics
NPI:1164424230
Name:JORDAN, RONALD P (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:P
Last Name:JORDAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TAGGART CT
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1085
Mailing Address - Country:US
Mailing Address - Phone:401-886-7100
Mailing Address - Fax:401-886-5682
Practice Address - Street 1:10 TAGGART CT
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1085
Practice Address - Country:US
Practice Address - Phone:401-886-7100
Practice Address - Fax:401-886-5682
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH02299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist