Provider Demographics
NPI:1437598117
Name:ROBINSON, DAVID ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21378 FAIR OAKS
Mailing Address - Street 2:
Mailing Address - City:NEVIS
Mailing Address - State:MN
Mailing Address - Zip Code:56467-2301
Mailing Address - Country:US
Mailing Address - Phone:701-570-3795
Mailing Address - Fax:218-547-1496
Practice Address - Street 1:21378 FAIR OAKS
Practice Address - Street 2:
Practice Address - City:NEVIS
Practice Address - State:MN
Practice Address - Zip Code:56467-2301
Practice Address - Country:US
Practice Address - Phone:701-570-3795
Practice Address - Fax:218-547-1496
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118464183500000X
ND3987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist