Provider Demographics
NPI:1669460747
Name:RONCI FAMILY DISCOUNT DRUGS,INC
Entity Type:Organization
Organization Name:RONCI FAMILY DISCOUNT DRUGS,INC
Other - Org Name:CORNERSBURG FAMILY DISCOUNT DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:RONCI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-792-7654
Mailing Address - Street 1:3307 CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-2811
Mailing Address - Country:US
Mailing Address - Phone:330-792-7654
Mailing Address - Fax:330-792-6802
Practice Address - Street 1:3307 CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-2811
Practice Address - Country:US
Practice Address - Phone:330-792-7654
Practice Address - Fax:330-792-6802
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RONCI FAMILY DISCOUNT DRUGS,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-12
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02463850332B00000X
OH02-4638503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1780701Medicaid
OH1780701Medicaid
OH0687900002Medicare NSC