Provider Demographics
NPI:1184842189
Name:ROLLINS, ISRAEL E JR (RPH)
Entity Type:Individual
Prefix:
First Name:ISRAEL
Middle Name:E
Last Name:ROLLINS
Suffix:JR
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 1:260 CENTERVIEW DRIVE SUITE 390
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-574-0528
Mailing Address - Fax:615-690-0837
Practice Address - Street 1:260 CENTERVIEW DR
Practice Address - Street 2:SUITE 390
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-574-0528
Practice Address - Fax:615-690-0837
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS250211835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy