Provider Demographics
NPI:1366028565
Name:KING, RAMONA HESTER (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:HESTER
Last Name:KING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4395 LEISURE LAKES DR
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-5652
Mailing Address - Country:US
Mailing Address - Phone:850-832-3849
Mailing Address - Fax:
Practice Address - Street 1:1037 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-1930
Practice Address - Country:US
Practice Address - Phone:850-832-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU3835183500000X
FLPS23998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty