Active NPI
Michelle Ann Rolle, PHARMD
- Pharmacy
- Riverside, CA
National Provider Identifier
1356989610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 61403
- Practice address
- 6215 Riverside Ave
Riverside, CA 92506-2179 - Phone
- (951) 781-0146
- Fax
- (951) 781-0816
- NPI assigned
- Dec 18, 2019
- Last updated
- Dec 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 61403 | CA | Primary |
Addresses
Primary practice location
6215 Riverside Ave
Riverside, CA 92506-2179
Mailing address
7651 Ayr CT
Riverside, CA 92508-6094
Phone (951) 533-6603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61403 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Pharmacy | Past | Accepting new patients |
| Garfield Beach CVS, L.L.C. | Pharmacy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576627200000",
"number": "1356989610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7651 AYR CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925086094",
"telephone_number": "951-533-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6215 RIVERSIDE AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062179",
"telephone_number": "951-781-0146",
"fax_number": "951-781-0816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLE",
"first_name": "MICHELLE",
"middle_name": "ANN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-18",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "61403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "61403",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.