Provider Demographics
NPI:1871515247
Name:WEST, RONALD LYNN (RPH)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LYNN
Last Name:WEST
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 W WEIR RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-7702
Mailing Address - Country:US
Mailing Address - Phone:812-752-4216
Mailing Address - Fax:
Practice Address - Street 1:120 W MCCLAIN AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-2046
Practice Address - Country:US
Practice Address - Phone:812-752-2021
Practice Address - Fax:812-752-7688
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013674A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist