Provider Demographics
NPI:1194256982
Name:FALLER, RONALD
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:FALLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 HOUSTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3624
Mailing Address - Country:US
Mailing Address - Phone:412-364-1419
Mailing Address - Fax:
Practice Address - Street 1:4900 PERRY HWY
Practice Address - Street 2:BLDG 1, SUITE 101
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229-2220
Practice Address - Country:US
Practice Address - Phone:412-931-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032605L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist