Ronnie Lane Poe, PHARMACIST
Individual provider Active NPI Pharmacist · Shaw, MS
NPI 1629124516 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629124516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E6449 (MS)
- Practice address
- 118 E Peeler Ave
Shaw, MS 38773 - Phone
- (662) 754-2241
- Fax
- (662) 754-2362
- NPI assigned
- Jan 25, 2007
- 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 |
|---|---|---|---|
| E6449 | MS | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E6449 | MS | Yes |
Addresses
Primary practice location
118 E Peeler Ave
Shaw, MS 38773
Mailing address
517 Anne Stokes Rd
Greenville, MS 38701-6904
Phone (662) 332-9516
Other providers in Shaw, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.