Provider Demographics
NPI:1437421542
Name:ROBINSON, RANDI KAY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:KAY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-1318
Mailing Address - Country:US
Mailing Address - Phone:304-562-2677
Mailing Address - Fax:304-562-0629
Practice Address - Street 1:3109 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-1318
Practice Address - Country:US
Practice Address - Phone:304-562-2677
Practice Address - Fax:304-562-0629
Is Sole Proprietor?:No
Enumeration Date:2012-02-04
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist