Provider Demographics
NPI:1528033255
Name:HUNTLEY, ROBERT E JR (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:HUNTLEY
Suffix:JR
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 PICKWICK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-8248
Mailing Address - Country:US
Mailing Address - Phone:803-699-9691
Mailing Address - Fax:
Practice Address - Street 1:MONCRIEF ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:4500 STUART ST
Practice Address - City:FT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207
Practice Address - Country:US
Practice Address - Phone:803-751-2385
Practice Address - Fax:803-751-0547
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC009044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist