Provider Demographics
NPI:1023513876
Name:BROTON, ROSS
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:BROTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30396 ANDERSON DR UNIT 208
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-3857
Mailing Address - Country:US
Mailing Address - Phone:717-683-5950
Mailing Address - Fax:
Practice Address - Street 1:26191 JOHN J WILLIAMS HWY
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-4950
Practice Address - Country:US
Practice Address - Phone:302-945-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0005083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist