Provider Demographics
NPI:1497137723
Name:RUFFIN, ROSHANDA RENEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSHANDA
Middle Name:RENEE
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 GLEN IRIS DR
Mailing Address - Street 2:APARTMENT 203
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-6190
Mailing Address - Country:US
Mailing Address - Phone:910-862-2076
Mailing Address - Fax:910-862-2022
Practice Address - Street 1:1351 GLEN IRIS DR
Practice Address - Street 2:APARTMENT 203
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-6190
Practice Address - Country:US
Practice Address - Phone:910-862-2076
Practice Address - Fax:910-862-2022
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist