Provider Demographics
NPI:1649384207
Name:PALMER, RONALD REEVES (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:REEVES
Last Name:PALMER
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 1:5222 E ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5890
Mailing Address - Country:US
Mailing Address - Phone:602-342-2671
Mailing Address - Fax:480-342-2888
Practice Address - Street 1:5777 E MAYO BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-4502
Practice Address - Country:US
Practice Address - Phone:480-342-2671
Practice Address - Fax:480-342-2888
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7193183500000X
KS1-09983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist