Healthcare Provider Details

I. General information

NPI: 1487670337
Provider Name (Legal Business Name): ROHO ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 FORT CAMPBELL BLVD
HOPKINSVILLE KY
42240-4669
US

IV. Provider business mailing address

2412 FORT CAMPBELL BLVD
HOPKINSVILLE KY
42240-4669
US

V. Phone/Fax

Practice location:
  • Phone: 270-885-6025
  • Fax: 270-885-5325
Mailing address:
  • Phone: 270-885-6025
  • Fax: 270-885-5325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberP07063
License Number StateKY

VIII. Authorized Official

Name: THOMAS ROSS
Title or Position: MANAGER
Credential: RPH
Phone: 270-885-6025