Provider Demographics
NPI:1174384788
Name:ROLLINS VENTURES LLC
Entity type:Organization
Organization Name:ROLLINS VENTURES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-317-5550
Mailing Address - Street 1:3059 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:EAST FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:16637-8023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3059 EVERETT RD
Practice Address - Street 2:
Practice Address - City:EAST FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:16637-8023
Practice Address - Country:US
Practice Address - Phone:347-236-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROLLINS VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-22
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care