Provider Demographics
NPI:1093797342
Name:ROLAND, KEITH ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:ROBERT
Last Name:ROLAND
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 OLD PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3418
Mailing Address - Country:US
Mailing Address - Phone:717-295-4446
Mailing Address - Fax:
Practice Address - Street 1:3001 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9414
Practice Address - Country:US
Practice Address - Phone:717-560-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044292L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist