Healthcare Provider Details

I. General information

NPI: 1023617693
Provider Name (Legal Business Name): RONALD OPRIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S GILBERT RD
MESA AZ
85204-5205
US

IV. Provider business mailing address

17777 N SCOTTSDALE RD
SCOTTSDALE AZ
85255-6572
US

V. Phone/Fax

Practice location:
  • Phone: 480-926-1108
  • Fax:
Mailing address:
  • Phone: 630-401-6568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024607
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: