Individual
MARY ANN ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
19118 ALBERTA ST, ONEIDA, TN 37841-6003
(423) 569-9000
(423) 569-2402
Mailing address
19118 ALBERTA ST, ONEIDA, TN 37841-6003
(423) 569-9000
(423) 569-2402
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
010025
KY
183500000X
Pharmacist
Primary
7478
TN
183500000X
Pharmacist
PS 19818
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7478
PHARMACIST LIC NUMBER
TN
Enumeration date
11/14/2006
Last updated
07/08/2007
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