Provider Demographics
NPI:1831187400
Name:ROTZ, JOHN S (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:S
Last Name:ROTZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3008
Mailing Address - Country:US
Mailing Address - Phone:540-662-8312
Mailing Address - Fax:540-665-2060
Practice Address - Street 1:1338 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3008
Practice Address - Country:US
Practice Address - Phone:540-662-8312
Practice Address - Fax:540-665-2060
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist