Provider Demographics
NPI:1174915789
Name:ROCKWELL PHARMACEUTICALS,LLC
Entity type:Organization
Organization Name:ROCKWELL PHARMACEUTICALS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MARTI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:251-689-6551
Mailing Address - Street 1:PO BOX 1492
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-1492
Mailing Address - Country:US
Mailing Address - Phone:251-689-6551
Mailing Address - Fax:251-472-0864
Practice Address - Street 1:1410 US HIGHWAY 98
Practice Address - Street 2:SUITE K
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-5110
Practice Address - Country:US
Practice Address - Phone:251-689-6551
Practice Address - Fax:251-472-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy