Healthcare Provider Details

I. General information

NPI: 1326642299
Provider Name (Legal Business Name): DEBORAH KAY ROKISKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 11/22/2020
Certification Date: 11/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 KINGSRIDGE DR
DAYTON OH
45458-1616
US

IV. Provider business mailing address

1271 BELVO ESTATES DR
MIAMISBURG OH
45342-3895
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-8533
  • Fax:
Mailing address:
  • Phone: 937-231-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03319892
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: