Provider Demographics
NPI:1649573809
Name:ROCKHOLT, DAVID KYLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KYLE
Last Name:ROCKHOLT
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 1:1295 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5947
Mailing Address - Country:US
Mailing Address - Phone:803-324-7563
Mailing Address - Fax:
Practice Address - Street 1:1295 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5947
Practice Address - Country:US
Practice Address - Phone:803-324-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13040183500000X
NC21652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist