Elijah Royal Rock

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

30259949

Practice address

30485 County Road 16
Elkhart, IN 46516-1006

Phone

(574) 326-4622

NPI assigned

Sep 19, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1437986791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30485 COUNTY ROAD 16",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465161006",
            "telephone_number": "574-326-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30485 COUNTY ROAD 16",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465161006",
            "telephone_number": "574-326-4622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 McClintock Ave Apt H572",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900073547",
            "country_code": "US",
            "telephone_number": "574-326-4622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCK",
        "first_name": "ELIJAH",
        "middle_name": "ROYAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "TCH198036",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "IN",
            "license": "67043053A",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": "30259949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle R Roberts
• Victoria Roberts
• Alison Rae Robertson, D.D.S.
• Tina M Robertson, LCAC, LSW
• Kristen Marie Robson, BCBA
• Kelsey Marie Rockstroh, BSN, RN
• Rocky Mountain Holdings, LLC
• Cassandra Rodabaugh
• Aslisia Rodgers, BA
• Kristin J Rodzinka, HSPP

• Pharmacy Technician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Pharmacy Technician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.