Provider Demographics
NPI:1225149164
Name:SHARPE, RONNY WAYNE (CRTT)
Entity Type:Individual
Prefix:
First Name:RONNY
Middle Name:WAYNE
Last Name:SHARPE
Suffix:
Gender:M
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:DADEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36853-6200
Mailing Address - Country:US
Mailing Address - Phone:256-825-8501
Mailing Address - Fax:256-825-0369
Practice Address - Street 1:1540 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:DADEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36853-6200
Practice Address - Country:US
Practice Address - Phone:256-825-8501
Practice Address - Fax:256-825-0369
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies