Provider Demographics
NPI:1033367438
Name:BORGER, ROBERT M (BS, RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:BORGER
Suffix:
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 WEST HIGHWAY 47
Mailing Address - Street 2:POST OFFICE BOX 1992
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568
Mailing Address - Country:US
Mailing Address - Phone:715-356-7726
Mailing Address - Fax:715-356-2856
Practice Address - Street 1:1143 WEST HIGHWAY 47
Practice Address - Street 2:POST OFFICE BOX 1992
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568
Practice Address - Country:US
Practice Address - Phone:715-356-7726
Practice Address - Fax:715-356-2856
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12779-040183500000X
IL051-027816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist