Basic Information
Provider Information | |||||||||
NPI: | 1386664118 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ROHRBAUGH | ||||||||
FirstName: | DAVID | ||||||||
MiddleName: | ALLEN | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | R.PH. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 8901 WISCONSIN AVE | ||||||||
Address2: |   | ||||||||
City: | BETHESDA | ||||||||
State: | MD | ||||||||
PostalCode: | 208890004 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3012957934 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 8901 WISCONSIN AVE | ||||||||
Address2: |   | ||||||||
City: | BETHESDA | ||||||||
State: | MD | ||||||||
PostalCode: | 20889 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3012954000 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/21/2006 | ||||||||
LastUpdateDate: | 08/03/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 0202205462 | VA | N |   | Pharmacy Service Providers | Pharmacist |   | 183500000X | 16197 | MD | N |   | Pharmacy Service Providers | Pharmacist |   | 183500000X | RP036830L | PA | Y |   | Pharmacy Service Providers | Pharmacist |   |
ID Information
ID | Type | State | Issuer | Description | RP036830L | 01 | PA | PHARMACIST LICENSE | OTHER | 59798 | 01 | MD | PHARMACIST LICENSE | OTHER | 0202205462 | 01 | VA | PHARMACIST LICENSE | OTHER |