Provider Demographics
NPI:1376879528
Name:PHILLIPS, BOB CHRISTOPHER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BOB
Middle Name:CHRISTOPHER
Last Name:PHILLIPS
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 1:4568 US HIGHWAY 220 N
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9412
Mailing Address - Country:US
Mailing Address - Phone:336-644-1765
Mailing Address - Fax:336-644-6525
Practice Address - Street 1:4568 US HIGHWAY 220 N
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9412
Practice Address - Country:US
Practice Address - Phone:336-644-1765
Practice Address - Fax:336-644-6525
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist