Provider Demographics
NPI:1417587825
Name:ZETTS, RONNY (PHARMACIST)
Entity type:Individual
Prefix:
First Name:RONNY
Middle Name:
Last Name:ZETTS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:RONNY
Other - Middle Name:K
Other - Last Name:ZETTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:308 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BORADMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512
Mailing Address - Country:US
Mailing Address - Phone:330-758-2824
Mailing Address - Fax:330-758-1435
Practice Address - Street 1:308 BOARDMAN-CANFIELD RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-758-2824
Practice Address - Fax:330-758-1435
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist