Provider Demographics
NPI:1225305998
Name:GERARD, RONALD (RP)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:GERARD
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13155 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3740
Mailing Address - Country:US
Mailing Address - Phone:402-334-9134
Mailing Address - Fax:402-334-5537
Practice Address - Street 1:13155 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3740
Practice Address - Country:US
Practice Address - Phone:402-334-9134
Practice Address - Fax:402-334-5537
Is Sole Proprietor?:No
Enumeration Date:2011-11-24
Last Update Date:2011-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE8801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist