Provider Demographics
NPI:1609224005
Name:ROSCHER, ADRIAAN FRANS (RPH)
Entity Type:Individual
Prefix:
First Name:ADRIAAN
Middle Name:FRANS
Last Name:ROSCHER
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 1:2518 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2106
Mailing Address - Country:US
Mailing Address - Phone:262-334-4033
Mailing Address - Fax:855-771-5058
Practice Address - Street 1:2518 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2106
Practice Address - Country:US
Practice Address - Phone:262-334-4033
Practice Address - Fax:855-771-5058
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI014259-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist