MEDICARE: MS. PATRICIA ANDERSON ROTENBERRY CPHT

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
1	183700000X	Pharmacy Technician	0230000442	VA

General Provider Information

NPI Number	:	1912978578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANDERSON ROTENBERRY CPHT

Provider Business Mailing Address
First Line	:	7059 W LEE HWY
Second Line	:	P.O. BOX 830
City	:	RURAL RETREAT
State	:	VA
Zip	:	24368-2933
Country	:	US
Telephone Number	:	276-686-6266
Fax Number	:	276-686-8229

Provider Business Practice Location Address
First Line	:	7059 W LEE HWY
Second Line	:
City	:	RURAL RETREAT
State	:	VA
Zip	:	24368-2933
Country	:	US
Telephone Number	:	276-686-6266
Fax Number	:	276-686-8229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/08/2007

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