Provider Demographics
NPI:1558772400
Name:ROBINSON FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:ROBINSON FAMILY PHARMACY LLC
Other - Org Name:ROBINSON FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-244-1134
Mailing Address - Street 1:213 N PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-3130
Mailing Address - Country:US
Mailing Address - Phone:903-796-1730
Mailing Address - Fax:903-796-1753
Practice Address - Street 1:213 N PINECREST DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-3130
Practice Address - Country:US
Practice Address - Phone:903-796-1730
Practice Address - Fax:903-796-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX292513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145686OtherPK