Provider Demographics
NPI:1710389291
Name:ROCK, ROBERT P (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P
Last Name:ROCK
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 1:831 GRAND CAILLOU RD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70363
Mailing Address - Country:US
Mailing Address - Phone:985-879-2440
Mailing Address - Fax:
Practice Address - Street 1:831 GRAND CAILLOU RD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363-5882
Practice Address - Country:US
Practice Address - Phone:985-879-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist