Provider Demographics
NPI:1225310980
Name:ROLLER, TODD (RPH)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:ROLLER
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 1:5355 MEDPACE WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1543
Mailing Address - Country:US
Mailing Address - Phone:513-366-3220
Mailing Address - Fax:
Practice Address - Street 1:5355 MEDPACE WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1543
Practice Address - Country:US
Practice Address - Phone:513-366-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293801183500000X
IN26023360A183500000X
OH03129446-1183500000X, 183500000X
AZS018427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist