MEDICARE: RON HERRINGTON 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	E06698	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1851318323	OTHER	MS	NPI

General Provider Information

NPI Number	:	1699292474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RON HERRINGTON RPH

Provider Business Mailing Address
First Line	:	2675 HIGHWAY 15
Second Line	:
City	:	BAY SPRINGS
State	:	MS
Zip	:	39422-7431
Country	:	US
Telephone Number	:	601-764-4342
Fax Number	:	601-764-3558

Provider Business Practice Location Address
First Line	:	2675 HIGHWAY 15
Second Line	:
City	:	BAY SPRINGS
State	:	MS
Zip	:	39422-7431
Country	:	US
Telephone Number	:	601-764-4342
Fax Number	:	601-764-3558

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

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	08/23/2017

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Directions to “ RON HERRINGTON RPH” Practice Location

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