Provider Demographics
NPI:1346844362
Name:MONDA, ROBINSON G (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBINSON
Middle Name:G
Last Name:MONDA
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 1:8346 WESTCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6743
Mailing Address - Country:US
Mailing Address - Phone:317-702-3027
Mailing Address - Fax:
Practice Address - Street 1:1950 STATE STREET, NEW ALBANY
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4920
Practice Address - Country:US
Practice Address - Phone:812-948-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028118A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26028118AOtherPHARMACIST STATE LICENSE NUMBER