MEDICARE: KIMBERLY RONCASE

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	RP446723	PA

General Provider Information

NPI Number	:	1346653987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY RONCASE

Provider Business Mailing Address
First Line	:	551 WASHINGTON ST
Second Line	:	APT B
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-2546
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3599 W CHESTER PIKE
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-3701
Country	:	US
Telephone Number	:	610-353-0294
Fax Number	:

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

Provider Enumeration Date	:	06/10/2014
Last Update Date	:	06/10/2014

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Directions to “ KIMBERLY RONCASE ” Practice Location

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