Healthcare Provider Details

I. General information

NPI: 1891954756
Provider Name (Legal Business Name): RONNIE BARKER OHANESIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5171 SAM JARED DR BLDG 112
MURFREESBORO TN
37130-1382
US

IV. Provider business mailing address

5171 SAM JARED DR BLDG 112
MURFREESBORO TN
37130-1382
US

V. Phone/Fax

Practice location:
  • Phone: 615-904-9727
  • Fax:
Mailing address:
  • Phone: 615-904-9727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28377
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: