Provider Demographics
NPI:1245511260
Name:RAMAGE, ARNOLD E (RPH)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:E
Last Name:RAMAGE
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 1:15189 BRADLEY LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-6299
Mailing Address - Country:US
Mailing Address - Phone:618-997-4803
Mailing Address - Fax:
Practice Address - Street 1:4 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:62946-1720
Practice Address - Country:US
Practice Address - Phone:618-252-0134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-30081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist