Provider Demographics
NPI:1821504648
Name:ELSNER, RALPH ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:ROBERT
Last Name:ELSNER
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:PO BOX 19
Mailing Address - Street 2:
Mailing Address - City:EDMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48829-0019
Mailing Address - Country:US
Mailing Address - Phone:989-427-5814
Mailing Address - Fax:
Practice Address - Street 1:326 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EDMORE
Practice Address - State:MI
Practice Address - Zip Code:48829-9810
Practice Address - Country:US
Practice Address - Phone:989-427-5814
Practice Address - Fax:989-427-5973
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302019925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist