Provider Demographics
NPI:1083742910
Name:FLEECE, ROBERT S (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:FLEECE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12168 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1642
Mailing Address - Country:US
Mailing Address - Phone:810-695-5419
Mailing Address - Fax:
Practice Address - Street 1:12724 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1831
Practice Address - Country:US
Practice Address - Phone:810-694-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist