Ronald Ethan Prater
Pharmacist, Pharmacotherapy in Bristol, TN. Individual provider (NPI-1).
NPI number1033713169
StatusActive
Last updated in NPPESNov 30, 2020
Details
- NPI
- 1033713169
- Entity type
- Individual (NPI-1)
- Name
- Ronald Ethan Prater
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 30, 2020
- Certification date
- Nov 27, 2020
- Last updated
- Nov 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P1200X | Pharmacist, Pharmacotherapy | 41545 | TN | Yes |
| 1835P1200X | Pharmacist, Pharmacotherapy | 0202216140 | VA |
Practice location
308 E Cedar StBristol, TN 37620-3928
Phone 423-968-7983
Mailing address
308 E Cedar StBristol, TN 37620-3928
Phone 423-968-7983
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