Provider Demographics
NPI:1265034193
Name:ALLEY, ROBERT R (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:ALLEY
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 1:140 FERRUM DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7118
Mailing Address - Country:US
Mailing Address - Phone:540-797-4039
Mailing Address - Fax:
Practice Address - Street 1:195 CONSTON AVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1151
Practice Address - Country:US
Practice Address - Phone:540-381-4037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist