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General NPI Number Information
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NPI Number | 1871688655
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Entity Type | Individual
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Provider Name | PAULA B ROLLER
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 105 SOUTH PUBLIC SQUARE
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City | ALEXANDRIA
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State | TN
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Zip | 37012
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Country | US
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Telephone | 615-529-2160
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Fax | 615-529-4442
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Provider Business Mailing Address
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Address Line | 5726 EAST GREEN HILL RD
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City | ROCK ISLAND
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State | TN
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Zip | 38581-4108
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Country | US
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Telephone | 931-686-3326
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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 | 4468
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License Number State | TN
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