Provider Demographics
NPI:1740758622
Name:CODER, ROSS W
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:W
Last Name:CODER
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 1:10 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:REEDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17084-9641
Mailing Address - Country:US
Mailing Address - Phone:717-363-9315
Mailing Address - Fax:717-363-9316
Practice Address - Street 1:10 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:REEDSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17084-9641
Practice Address - Country:US
Practice Address - Phone:717-363-9315
Practice Address - Fax:717-363-9316
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist