Healthcare Provider Details

I. General information

NPI: 1982153086
Provider Name (Legal Business Name): RONALD CLAYTON LAWRENCE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2016
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2182 HIGHWAY 4
ARNOLD CA
95223-9908
US

IV. Provider business mailing address

PO BOX 930
MURPHYS CA
95247-0930
US

V. Phone/Fax

Practice location:
  • Phone: 209-795-1155
  • Fax: 209-795-6862
Mailing address:
  • Phone: 209-304-6100
  • Fax: 209-728-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: