Provider Demographics
NPI:1841614765
Name:ROLLING, RAYMOND (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:ROLLING
Suffix:
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 1:35 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-1116
Mailing Address - Country:US
Mailing Address - Phone:985-264-6882
Mailing Address - Fax:
Practice Address - Street 1:35 PATRICIA DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-1116
Practice Address - Country:US
Practice Address - Phone:985-264-6882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist