Provider Demographics
NPI:1568692069
Name:CALDWELL, ROBERT MARTING (PHARMD, PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MARTING
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:PHARMACY, IHS HOSPITAL
Mailing Address - City:ROSEBUD
Mailing Address - State:SD
Mailing Address - Zip Code:57570-0400
Mailing Address - Country:US
Mailing Address - Phone:605-747-3256
Mailing Address - Fax:605-747-5335
Practice Address - Street 1:400 SOLDIER CREEK ROAD
Practice Address - Street 2:PHARMACY, IHS HOSPITAL
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570-0400
Practice Address - Country:US
Practice Address - Phone:605-747-3256
Practice Address - Fax:605-747-5335
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE128741835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy