Provider Demographics
NPI:1225331242
Name:MANN, ROSALYN COLEMAN (RPH)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:COLEMAN
Last Name:MANN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ROSALYN
Other - Middle Name:COLEMAN
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ROSALYN MANN
Mailing Address - Street 1:3250 FREEDOM DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-2817
Mailing Address - Country:US
Mailing Address - Phone:704-394-0118
Mailing Address - Fax:704-393-2893
Practice Address - Street 1:3250 FREEDOM DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-2817
Practice Address - Country:US
Practice Address - Phone:704-394-0118
Practice Address - Fax:704-393-2893
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist