Provider Demographics
NPI:1710986484
Name:RONALD J. MESSICK
Entity Type:Organization
Organization Name:RONALD J. MESSICK
Other - Org Name:REDSTONE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MESSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-938-2395
Mailing Address - Street 1:322 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:PA
Mailing Address - Zip Code:15419-1134
Mailing Address - Country:US
Mailing Address - Phone:724-938-2395
Mailing Address - Fax:724-938-8244
Practice Address - Street 1:322 3RD ST
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:PA
Practice Address - Zip Code:15419-1134
Practice Address - Country:US
Practice Address - Phone:724-938-2395
Practice Address - Fax:724-938-8244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA377IVI332B00000X
PAPP413276L333600000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011188830001Medicaid
PA0011188830001Medicaid