Provider Demographics
NPI:1912640061
Name:RAMOS, DOMINICK AGUILAR (CCMA, CPHT)
Entity Type:Individual
Prefix:
First Name:DOMINICK
Middle Name:AGUILAR
Last Name:RAMOS
Suffix:
Gender:M
Credentials:CCMA, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 W OCEAN VIEW AVE # B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-1015
Mailing Address - Country:US
Mailing Address - Phone:757-572-6843
Mailing Address - Fax:
Practice Address - Street 1:825 FAIRFAX AVE FL 6
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1912
Practice Address - Country:US
Practice Address - Phone:757-446-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230038180183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician