Provider Demographics
NPI:1972880227
Name:DUNFORD, ROCHELLE LYNNE (RPH)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:LYNNE
Last Name:DUNFORD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24900 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-4769
Mailing Address - Country:US
Mailing Address - Phone:586-774-3385
Mailing Address - Fax:586-774-5191
Practice Address - Street 1:24900 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-4769
Practice Address - Country:US
Practice Address - Phone:586-774-3385
Practice Address - Fax:586-774-5191
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist