Provider Demographics
NPI:1558608646
Name:SKINNER, ROBERT BROOKS (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BROOKS
Last Name:SKINNER
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 1:1300 DANA DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4071
Mailing Address - Country:US
Mailing Address - Phone:530-222-8097
Mailing Address - Fax:
Practice Address - Street 1:1300 DANA DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4071
Practice Address - Country:US
Practice Address - Phone:530-222-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH29547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist