Healthcare Provider Details

I. General information

NPI: 1700780871
Provider Name (Legal Business Name): PATRICK DANIEL ROLAND PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 N DIXIE AVE
ELIZABETHTOWN KY
42701-2503
US

IV. Provider business mailing address

913 N DIXIE AVE
ELIZABETHTOWN KY
42701-2503
US

V. Phone/Fax

Practice location:
  • Phone: 270-706-1668
  • Fax:
Mailing address:
  • Phone: 270-706-1668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number018889
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: