Provider Demographics
NPI:1346243995
Name:PITTMAN, ROBERT EDDY (RPH, MPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDDY
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:RPH, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5703 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1927
Mailing Address - Country:US
Mailing Address - Phone:301-230-2439
Mailing Address - Fax:
Practice Address - Street 1:INDIAN HEALTH SERVICE
Practice Address - Street 2:801 THOMPSON AVE, SUITE 300
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1627
Practice Address - Country:US
Practice Address - Phone:301-443-1190
Practice Address - Fax:301-443-8170
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist