Provider Demographics
NPI:1306852470
Name:WESTBROOK, ROBERT L JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:WESTBROOK
Suffix:JR
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 1:1400 S.R. 125
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1328
Mailing Address - Country:US
Mailing Address - Phone:513-753-4700
Mailing Address - Fax:513-753-3401
Practice Address - Street 1:1400 S.R. 125
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-1328
Practice Address - Country:US
Practice Address - Phone:513-753-4700
Practice Address - Fax:513-753-3401
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-9330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FV93161OtherMEDICARE B PIN