Provider Demographics
NPI:1699379701
Name:FARRELL, RONALD MATTHEW (PHARMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:MATTHEW
Last Name:FARRELL
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 1:4401 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1914
Mailing Address - Country:US
Mailing Address - Phone:352-596-1590
Mailing Address - Fax:352-835-4370
Practice Address - Street 1:4401 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1914
Practice Address - Country:US
Practice Address - Phone:352-596-1590
Practice Address - Fax:352-835-4370
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist