Provider Demographics
NPI:1114205366
Name:WIENER, ROBIN ANNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ANNE
Last Name:WIENER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4633
Mailing Address - Country:US
Mailing Address - Phone:336-547-7475
Mailing Address - Fax:336-286-2784
Practice Address - Street 1:3000 BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2708
Practice Address - Country:US
Practice Address - Phone:336-288-5676
Practice Address - Fax:336-286-2784
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC009670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist