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NPI Code Detail

MEDICARE: DR. RONALD F. LILLY BSPHARM,RPH, PD

MEDICARE: DR. RONALD F. LILLY BSPHARM,RPH, PD
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
1183500000XPharmacist2457WV

General Provider Information

NPI Number : 1841402294
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD F. LILLY BSPHARM,RPH, PD
Provider Business Mailing Address
First Line : 1186 DRY HILL RD
Second Line :
City : BECKLEY
State : WV
Zip : 25801-2156
Country : US
Telephone Number : 304-253-4885
Fax Number :
Provider Business Practice Location Address
First Line : 430 MAIN ST W
Second Line : PLATEAU MEDICAL CENTER PHARMACY
City : OAK HILL
State : WV
Zip : 25901-3414
Country : US
Telephone Number : 304-465-5785
Fax Number : 304-929-2465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2007
Last Update Date : 07/08/2007

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