Provider Demographics
NPI:1902071178
Name:ROSOWSKI, PAUL G (MS, RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:G
Last Name:ROSOWSKI
Suffix:
Gender:M
Credentials:MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 KINGS LYNN RD
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-4926
Mailing Address - Country:US
Mailing Address - Phone:608-877-1767
Mailing Address - Fax:
Practice Address - Street 1:924 KINGS LYNN RD
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-4926
Practice Address - Country:US
Practice Address - Phone:608-877-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist