Provider Demographics
NPI:1629291018
Name:ENO, RONALD VERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:VERT
Last Name:ENO
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 1:3421 TREE TOPS LN
Mailing Address - Street 2:
Mailing Address - City:VANDERBILT
Mailing Address - State:MI
Mailing Address - Zip Code:49795-9794
Mailing Address - Country:US
Mailing Address - Phone:989-983-3156
Mailing Address - Fax:
Practice Address - Street 1:3421 TREE TOPS LN
Practice Address - Street 2:
Practice Address - City:VANDERBILT
Practice Address - State:MI
Practice Address - Zip Code:49795-9794
Practice Address - Country:US
Practice Address - Phone:989-983-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist