Provider Demographics
NPI:1528558798
Name:ROLLINS, GERMAINE M
Entity Type:Individual
Prefix:MR
First Name:GERMAINE
Middle Name:M
Last Name:ROLLINS
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 1:78 FARNHAM CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:VA
Mailing Address - Zip Code:22572-4136
Mailing Address - Country:US
Mailing Address - Phone:804-238-3282
Mailing Address - Fax:
Practice Address - Street 1:78 FARNHAM CREEK RD
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572-4136
Practice Address - Country:US
Practice Address - Phone:804-238-3282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty