MEDICARE: MR. RONALD ALAN LAWNICZAK 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	16989	NV

General Provider Information

NPI Number	:	1184224073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD ALAN LAWNICZAK RPH

Provider Business Mailing Address
First Line	:	7445 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1538
Country	:	US
Telephone Number	:	702-407-5513
Fax Number	:	702-407-5591

Provider Business Practice Location Address
First Line	:	7445 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1538
Country	:	US
Telephone Number	:	702-407-5513
Fax Number	:	702-407-5591

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

Provider Enumeration Date	:	10/29/2020
Last Update Date	:	10/29/2020

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