Provider Demographics
NPI:1669736351
Name:MCGROARTY, RYAN (RPH)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MCGROARTY
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 1:409 STOKES RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8475
Mailing Address - Country:US
Mailing Address - Phone:609-654-0440
Mailing Address - Fax:
Practice Address - Street 1:409 STOKES RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8475
Practice Address - Country:US
Practice Address - Phone:609-654-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02802200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist