Provider Demographics
NPI:1790152932
Name:ONG, RALPH NATHANAEL TAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:RALPH NATHANAEL
Middle Name:TAN
Last Name:ONG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9551 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8117
Mailing Address - Country:US
Mailing Address - Phone:303-470-6445
Mailing Address - Fax:
Practice Address - Street 1:9551 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-8117
Practice Address - Country:US
Practice Address - Phone:303-470-6445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA 20922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist