Provider Demographics
NPI:1316154933
Name:FULMER, RONALD L (RPH)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:L
Last Name:FULMER
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 1:4587 OLD NC 18
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-9435
Mailing Address - Country:US
Mailing Address - Phone:828-438-1148
Mailing Address - Fax:828-432-0128
Practice Address - Street 1:240 MAIN ST W
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2835
Practice Address - Country:US
Practice Address - Phone:828-879-9812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist