Provider Demographics
NPI:1417513268
Name:ROSARIOSKI LLC
Entity Type:Organization
Organization Name:ROSARIOSKI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WISNIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-260-4460
Mailing Address - Street 1:42 TYLER DR
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1241
Mailing Address - Country:US
Mailing Address - Phone:215-260-4460
Mailing Address - Fax:
Practice Address - Street 1:334 MAIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:PA
Practice Address - Zip Code:17517-1448
Practice Address - Country:US
Practice Address - Phone:717-336-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy