Provider Demographics
NPI:1437203494
Name:HALBERT, RODERICK JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODERICK
Middle Name:JOHN
Last Name:HALBERT
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 1:34 OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1376
Mailing Address - Country:US
Mailing Address - Phone:732-291-0634
Mailing Address - Fax:
Practice Address - Street 1:34 OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1376
Practice Address - Country:US
Practice Address - Phone:732-291-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI17606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist