Provider Demographics
NPI:1912509332
Name:ACKUAYI, RONALD SELASIE SR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:SELASIE
Last Name:ACKUAYI
Suffix:SR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SWITCHYARD CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-1508
Mailing Address - Country:US
Mailing Address - Phone:571-331-1360
Mailing Address - Fax:
Practice Address - Street 1:1245 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4415
Practice Address - Country:US
Practice Address - Phone:540-371-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022214392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist