Provider Demographics
NPI:1679843262
Name:ROULHAC, ELMER H JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELMER
Middle Name:H
Last Name:ROULHAC
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1923
Mailing Address - Country:US
Mailing Address - Phone:304-697-2151
Mailing Address - Fax:
Practice Address - Street 1:125 7TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1923
Practice Address - Country:US
Practice Address - Phone:304-697-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007318183500000X
FLPS45892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist