Provider Demographics
NPI:1518465947
Name:RYHAL, CORY (PHARM D)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:
Last Name:RYHAL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 SAINT CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-4702
Mailing Address - Country:US
Mailing Address - Phone:330-720-4360
Mailing Address - Fax:
Practice Address - Street 1:501 E EVESHAM RD
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1865
Practice Address - Country:US
Practice Address - Phone:856-939-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03887300183500000X
PARP451760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RJ07380OtherNEW JERSEY BOARD OF PHARMACY
PARP451760OtherPENNSYLVANIA BOARD OF PHARMACY
PARPI011650OtherPENNSYLVANIA BOARD OF PHARMACY
NJ28RI03887300OtherNEW JERSEY BOARD OF PHARMACY