Provider Demographics
NPI:1457071052
Name:RANSOM, DEBRA JEAN
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JEAN
Last Name:RANSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-4115
Mailing Address - Country:US
Mailing Address - Phone:508-394-1325
Mailing Address - Fax:508-760-9717
Practice Address - Street 1:1041 ROUTE 28
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-4115
Practice Address - Country:US
Practice Address - Phone:508-394-1325
Practice Address - Fax:508-760-9717
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist