Provider Demographics
NPI:1265028583
Name:RON GROUP
Entity Type:Organization
Organization Name:RON GROUP
Other - Org Name:BLUE SKY SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CHISUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-352-7662
Mailing Address - Street 1:1501 BELLE ISLE AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8381
Mailing Address - Country:US
Mailing Address - Phone:843-352-7662
Mailing Address - Fax:
Practice Address - Street 1:1501 BELLE ISLE AVE STE 150
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8381
Practice Address - Country:US
Practice Address - Phone:843-352-7662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ558966Medicaid
KS201252280AMedicaid
NC566127Medicaid
FL104164100Medicaid
TNQ057548Medicaid
OR500780945Medicaid
KY7100619490Medicaid
SC715688Medicaid