Provider Demographics
NPI:1548983596
Name:ROTICH, SILAS KIPKURUI (RPH)
Entity type:Individual
Prefix:DR
First Name:SILAS
Middle Name:KIPKURUI
Last Name:ROTICH
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 1:1312 E 21ST TER
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-3268
Mailing Address - Country:US
Mailing Address - Phone:785-979-0250
Mailing Address - Fax:
Practice Address - Street 1:110 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1106
Practice Address - Country:US
Practice Address - Phone:913-856-0280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-100903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist