Organization Name: | ROBERTS PHARMACY INC |
NPI Number: | 1710902531 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACK H MILLS (PRESIDENT) |
Mailing Address: | 803 N Wiley Ave Donalsonville |
State: | GA US |
Postal Code: | 398451121 |
Phone Number: | 2295242313 |
Fax Number: | 2295241202 |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 12/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BP3500X |
License Number: | PHRE004506 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Parenteral & Enteral Nutrition |
Taxonomy Definition: |