Provider Demographics
NPI:1154635449
Name:BRINK, ROBERT H (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:BRINK
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 DALTON PIKE SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-6988
Mailing Address - Country:US
Mailing Address - Phone:423-478-3850
Mailing Address - Fax:423-478-1365
Practice Address - Street 1:1805 DALTON PIKE SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-6988
Practice Address - Country:US
Practice Address - Phone:423-478-3850
Practice Address - Fax:423-478-1365
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist