MEDICARE: MR. RONALD E BENNETT RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202010021	VA

General Provider Information

NPI Number	:	1952295883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD E BENNETT RPH

Provider Business Mailing Address
First Line	:	1520 EGGLESTON FALLS RD
Second Line	:
City	:	RIDGEWAY
State	:	VA
Zip	:	24148-4466
Country	:	US
Telephone Number	:	276-340-2219
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 VIRGINIA AVE
Second Line	:
City	:	COLLINSVILLE
State	:	VA
Zip	:	24078-2244
Country	:	US
Telephone Number	:	276-647-3886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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