Ronald Leo Desrosiers
Individual provider Active NPI Pharmacist · Dracut, MA
NPI 1164026035 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1164026035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH19481 (MA)
- Practice address
- 2019 Lakeview Ave
Dracut, MA 01826-3224 - Phone
- (978) 957-6550
- NPI assigned
- Nov 23, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH19481 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH19481 | MA | Yes |
Addresses
Primary practice location
2019 Lakeview Ave
Dracut, MA 01826-3224
Mailing address
2019 Lakeview Ave
Dracut, MA 01826-3224
Phone (978) 957-6550
Other providers in Dracut, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.