Provider Demographics
NPI:1265723035
Name:TKACH, RONALD FRANCIS
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:FRANCIS
Last Name:TKACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MARSHALL ST N
Mailing Address - Street 2:
Mailing Address - City:BENWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26031-1024
Mailing Address - Country:US
Mailing Address - Phone:304-232-6103
Mailing Address - Fax:304-232-8642
Practice Address - Street 1:205 MARSHALL ST N
Practice Address - Street 2:
Practice Address - City:BENWOOD
Practice Address - State:WV
Practice Address - Zip Code:26031-1024
Practice Address - Country:US
Practice Address - Phone:304-232-6103
Practice Address - Fax:304-232-8642
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035787R183500000X
WV4674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist