Provider Demographics
NPI:1871638692
Name:SANKS, RALPH JAMES (RPH)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:JAMES
Last Name:SANKS
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 1:1818 74TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8611
Mailing Address - Country:US
Mailing Address - Phone:970-330-4459
Mailing Address - Fax:
Practice Address - Street 1:1801 16TH ST
Practice Address - Street 2:PHARMACY
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5154
Practice Address - Country:US
Practice Address - Phone:970-350-6351
Practice Address - Fax:970-350-6373
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist