Provider Demographics
NPI:1316378375
Name:JUSTICE, ROBIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3026
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-3026
Mailing Address - Country:US
Mailing Address - Phone:606-437-4144
Mailing Address - Fax:606-478-3788
Practice Address - Street 1:160 CONN STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:IVEL
Practice Address - State:KY
Practice Address - Zip Code:41642
Practice Address - Country:US
Practice Address - Phone:606-478-3784
Practice Address - Fax:606-478-3788
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011430183500000X
GA018422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist