Provider Demographics
NPI:1720577075
Name:CAMPOS, RONALD (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:CAMPOS
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 1:20 LILAC PL
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2676
Mailing Address - Country:US
Mailing Address - Phone:732-547-5725
Mailing Address - Fax:
Practice Address - Street 1:20 LILAC PL
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2676
Practice Address - Country:US
Practice Address - Phone:732-547-5725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01529300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist