Provider Demographics
NPI:1578801759
Name:GEYER, ROBERT H JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:GEYER
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 HIGHWAY 71 S
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-4638
Mailing Address - Country:US
Mailing Address - Phone:479-394-3254
Mailing Address - Fax:479-394-0235
Practice Address - Street 1:204 HIGHWAY 71 S
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-4638
Practice Address - Country:US
Practice Address - Phone:479-394-3254
Practice Address - Fax:479-394-0235
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD04373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist