Rodney Lee Rogalla, RPH
Individual provider Active NPI Pharmacist · Rothschild, WI
NPI 1487084232 · NPPES record last updated Nov 14, 2013
Key facts
- NPI
- 1487084232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 867340 (WI)
- Practice address
- 1105 E Grand Ave
Rothschild, WI 54474-1024 - Phone
- (715) 359-4251
- Fax
- (715) 359-0145
- NPI assigned
- Nov 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 867340 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 867340 | WI | Yes |
Addresses
Primary practice location
1105 E Grand Ave
Rothschild, WI 54474-1024
Mailing address
1105 E Grand Ave
Rothschild, WI 54474-1024
Phone (715) 359-4251
Other providers in Rothschild, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.