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General NPI Number Information
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NPI Number | 1760817878
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Entity Type | Organization
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Legal Business Name | ROCHE NUTRITION, INC.
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Dates
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Enumeration Date | 09/08/2013
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Last Update Date | 09/08/2013
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Provider Practice Location Address
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Address Line | 3031 GORHAM CT
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City | CARMEL
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State | IN
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Zip | 46033-3280
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Country | US
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Telephone | 317-850-8497
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Fax | 317-848-6373
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Provider Business Mailing Address
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Address Line | 3031 GORHAM COURT
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City | CARMEL
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State | IN
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Zip | 46033-3280
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Country | US
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Telephone | 317-850-8497
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Fax | 317-848-6373
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Authorized Official
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Title or Position | CEO
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Name | MS. PATRICIA L. ROCHE
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Credential | MS, RD, CD
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Telephone | 317-850-8497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 37000123A
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License Number State | IN
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