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NPI Code Detail

MEDICARE: MRS. ROLA METHOD

MEDICARE: MRS. ROLA METHOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist57352CA

General Provider Information

NPI Number : 1609159235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROLA METHOD
Provider Business Mailing Address
First Line : 18427 VINCENNES ST UNIT 2
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91325-2174
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15316 NORDHOFF ST
Second Line :
City : NORTH HILLS
State : CA
Zip : 91343-2234
Country : US
Telephone Number : 818-892-4249
Fax Number : 818-892-6273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2011
Last Update Date : 09/20/2011

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