Provider Demographics
NPI:1154545689
Name:VADURRO, RONALD (RP)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:VADURRO
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WOODLAND TER
Mailing Address - Street 2:
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1518
Mailing Address - Country:US
Mailing Address - Phone:856-854-5156
Mailing Address - Fax:
Practice Address - Street 1:100 N BLACKHORSE PIKE
Practice Address - Street 2:ACME SAV-0N PHARMACY
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-0000
Practice Address - Country:US
Practice Address - Phone:856-616-2484
Practice Address - Fax:856-310-1507
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01654700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist