Provider Demographics
NPI:1174668115
Name:ROCHELLE, GREG M (PHARMD)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:M
Last Name:ROCHELLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 AKAL CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7549
Mailing Address - Country:US
Mailing Address - Phone:919-806-8028
Mailing Address - Fax:
Practice Address - Street 1:3 AKAL CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7549
Practice Address - Country:US
Practice Address - Phone:919-806-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist