Provider Demographics
NPI:1649517533
Name:ROTCH, JEANNA PARKER (PHARMD)
Entity type:Individual
Prefix:
First Name:JEANNA
Middle Name:PARKER
Last Name:ROTCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CHELSEA CROSSROADS
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-3900
Mailing Address - Country:US
Mailing Address - Phone:205-678-5594
Mailing Address - Fax:205-678-5599
Practice Address - Street 1:501 CHELSEA CROSSROADS
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043-3900
Practice Address - Country:US
Practice Address - Phone:205-678-5594
Practice Address - Fax:205-678-5599
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist