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General NPI Number Information
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NPI Number | 1548774136
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Entity Type | Individual
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Provider Name | SUSAN ANN RODACK RPH
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Gender | Female
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Dates
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Enumeration Date | 11/19/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 115 PITTSBURGH ST
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City | SAXONBURG
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State | PA
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Zip | 16056-9563
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Country | US
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Telephone | 724-352-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 143 DAVID DR
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City | BUTLER
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State | PA
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Zip | 16001-2730
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Country | US
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Telephone | 724-282-0125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP030303L
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License Number State | PA
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