Provider Demographics
NPI:1790927424
Name:RANRAM LLC
Entity Type:Organization
Organization Name:RANRAM LLC
Other - Org Name:OCEAN PLAZA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMACHANDRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-343-6367
Mailing Address - Street 1:1740 BOCA CHICA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8146
Mailing Address - Country:US
Mailing Address - Phone:956-504-1290
Mailing Address - Fax:956-504-1292
Practice Address - Street 1:1740 BOCA CHICA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8146
Practice Address - Country:US
Practice Address - Phone:956-504-1290
Practice Address - Fax:956-504-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX283213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138753OtherPK
TX146671Medicaid