Provider Demographics
NPI:1164825865
Name:CULOTTA, RODNEY (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:
Last Name:CULOTTA
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 1:1021 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?:Yes
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMA.001415183500000X
LAPIC.011138183500000X
LAPST.011138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist