Provider Demographics
NPI:1467746727
Name:ROTTER, HARRY WILLIAM
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:WILLIAM
Last Name:ROTTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 5TH STREET HWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-1738
Mailing Address - Country:US
Mailing Address - Phone:610-921-5141
Mailing Address - Fax:610-921-5151
Practice Address - Street 1:4220 5TH STREET HWY
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1738
Practice Address - Country:US
Practice Address - Phone:610-921-5141
Practice Address - Fax:610-921-5151
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032806T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist