Provider Demographics
NPI:1104371673
Name:CULOTTA, RODI
Entity Type:Individual
Prefix:
First Name:RODI
Middle Name:
Last Name:CULOTTA
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 1:1021 W JUDGE PEREZ DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4703
Mailing Address - Country:US
Mailing Address - Phone:504-279-6312
Mailing Address - Fax:504-279-6314
Practice Address - Street 1:1021 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4703
Practice Address - Country:US
Practice Address - Phone:504-279-6312
Practice Address - Fax:504-279-6314
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.010763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist