Provider Demographics
NPI:1255742318
Name:POLING, RONALD (RPH)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:POLING
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 1:830 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-8756
Mailing Address - Country:US
Mailing Address - Phone:937-339-4733
Mailing Address - Fax:
Practice Address - Street 1:1900 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1017
Practice Address - Country:US
Practice Address - Phone:937-335-1811
Practice Address - Fax:937-332-0565
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031109171835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy