Provider Demographics
NPI:1275815086
Name:CAVARETTA, RONALD CHARLES JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:CHARLES
Last Name:CAVARETTA
Suffix:JR
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 1:365 WINCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-1938
Mailing Address - Country:US
Mailing Address - Phone:985-778-9544
Mailing Address - Fax:
Practice Address - Street 1:365 WINCHESTER CIR
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-1938
Practice Address - Country:US
Practice Address - Phone:985-778-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18866183500000X
MAPH19477183500000X
MS09528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist