Provider Demographics
NPI:1346497351
Name:HOLBROOK, ROBERT DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:HOLBROOK
Suffix:
Gender:M
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 1191
Mailing Address - Street 2:
Mailing Address - City:POUND
Mailing Address - State:VA
Mailing Address - Zip Code:24279-1191
Mailing Address - Country:US
Mailing Address - Phone:276-796-7340
Mailing Address - Fax:423-968-3933
Practice Address - Street 1:2854 W STATE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1711
Practice Address - Country:US
Practice Address - Phone:423-968-7032
Practice Address - Fax:423-968-3933
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN09845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN09845OtherBOARD OF PHARMACY