Provider Demographics
NPI:1912042656
Name:WOODBECK, RONALD G (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:G
Last Name:WOODBECK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9229 E EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-0822
Mailing Address - Country:US
Mailing Address - Phone:480-895-7691
Mailing Address - Fax:480-895-7691
Practice Address - Street 1:9546 E. RIGGS RD.
Practice Address - Street 2:
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248
Practice Address - Country:US
Practice Address - Phone:480-895-3063
Practice Address - Fax:480-895-5934
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist