Provider Demographics
NPI:1831270107
Name:REMIKER, RONALD LEE (RPH)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:LEE
Last Name:REMIKER
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:N11934 POST LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELCHO
Mailing Address - State:WI
Mailing Address - Zip Code:54428
Mailing Address - Country:US
Mailing Address - Phone:715-275-5087
Mailing Address - Fax:
Practice Address - Street 1:536 5TH AVE
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409
Practice Address - Country:US
Practice Address - Phone:715-623-2631
Practice Address - Fax:715-623-6887
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7993040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist