Provider Demographics
NPI:1477836807
Name:CAVALIER, RONALD A JR (RPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:CAVALIER
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 1:757 GALLIVAN BLVD
Mailing Address - Street 2:C/O WALGREENS #01847
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3109
Mailing Address - Country:US
Mailing Address - Phone:617-282-5246
Mailing Address - Fax:617-288-5242
Practice Address - Street 1:757 GALLIVAN BLVD
Practice Address - Street 2:C/O WALGREENS #01847
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3109
Practice Address - Country:US
Practice Address - Phone:617-282-5246
Practice Address - Fax:617-288-5242
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist