Provider Demographics
NPI:1003345257
Name:SHEALEY, ROBIN S (RPH)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:S
Last Name:SHEALEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:ROBIN
Other - Middle Name:S
Other - Last Name:LINDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:634-A PINE RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29172
Mailing Address - Country:US
Mailing Address - Phone:803-955-3404
Mailing Address - Fax:803-955-3406
Practice Address - Street 1:634-A PINE RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29172
Practice Address - Country:US
Practice Address - Phone:803-955-3404
Practice Address - Fax:803-955-3406
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88471835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care