Provider Demographics
NPI:1467513903
Name:KEIL, RONALD LEE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:LEE
Last Name:KEIL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 CARL RD
Mailing Address - Street 2:
Mailing Address - City:RESCUE
Mailing Address - State:CA
Mailing Address - Zip Code:95672-9604
Mailing Address - Country:US
Mailing Address - Phone:530-672-4222
Mailing Address - Fax:
Practice Address - Street 1:7563 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-3917
Practice Address - Country:US
Practice Address - Phone:530-622-2323
Practice Address - Fax:530-622-2011
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH29536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist