Healthcare Provider Details

I. General information

NPI: 1609801349
Provider Name (Legal Business Name): DONALD D RONE III PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E MAIN ST
PORTAGEVILLE MO
63873-1614
US

IV. Provider business mailing address

222 E MAIN ST
PORTAGEVILLE MO
63873-1614
US

V. Phone/Fax

Practice location:
  • Phone: 573-379-5469
  • Fax: 573-379-5459
Mailing address:
  • Phone: 573-379-5469
  • Fax: 573-379-5459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number006470
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: