Provider Demographics
NPI:1346835089
Name:ROGALSKI, CAROL A
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:ROGALSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 STILLWATER RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01342-9725
Mailing Address - Country:US
Mailing Address - Phone:413-475-0353
Mailing Address - Fax:
Practice Address - Street 1:298 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1971
Practice Address - Country:US
Practice Address - Phone:413-733-1423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH20984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist