Provider Demographics
NPI:1972277648
Name:RATLIFF, RODNEY S (RPH)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:S
Last Name:RATLIFF
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 1:398 CLINIC RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609-9413
Mailing Address - Country:US
Mailing Address - Phone:276-963-6600
Mailing Address - Fax:276-963-6666
Practice Address - Street 1:398 CLINIC RD
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609-9413
Practice Address - Country:US
Practice Address - Phone:276-963-6600
Practice Address - Fax:276-963-6666
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist