Provider Demographics
NPI:1215210562
Name:ROBINSON, KELLY ANN (RPH)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:ROBINSON
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 1:1991 FISHINGER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:OH
Mailing Address - Zip Code:43221
Mailing Address - Country:US
Mailing Address - Phone:614-264-9424
Mailing Address - Fax:
Practice Address - Street 1:OHIO STATE OUTPATIENT PHARMACY
Practice Address - Street 2:460 W. 10TH AVE
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-5920
Practice Address - Fax:614-366-0097
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist