Provider Demographics
NPI:1477623478
Name:HARWELL, RONALD R (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:R
Last Name:HARWELL
Suffix:
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 1:2299 ROME JONES RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9032
Mailing Address - Country:US
Mailing Address - Phone:828-465-2221
Mailing Address - Fax:
Practice Address - Street 1:317 1ST ST E
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-1715
Practice Address - Country:US
Practice Address - Phone:828-464-4491
Practice Address - Fax:828-464-4495
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0185751Medicaid
NC1217220001Medicare ID - Type Unspecified