Provider Demographics
NPI:1629478078
Name:GERARDO, RONALD V (PHARMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:V
Last Name:GERARDO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 ANNIE OAKLEY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3914
Mailing Address - Country:US
Mailing Address - Phone:800-713-0744
Mailing Address - Fax:
Practice Address - Street 1:6225 ANNIE OAKLEY DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3914
Practice Address - Country:US
Practice Address - Phone:800-713-0744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15779183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist