Provider Demographics
NPI:1730209842
Name:ROKOSZ, DAVID FRANK (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:FRANK
Last Name:ROKOSZ
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 1:1626 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-4323
Mailing Address - Country:US
Mailing Address - Phone:765-966-2225
Mailing Address - Fax:765-966-4362
Practice Address - Street 1:1626 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-4323
Practice Address - Country:US
Practice Address - Phone:765-966-2225
Practice Address - Fax:765-966-4362
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist