Provider Demographics
NPI:1598892218
Name:MULLINS, ROBERT DANIEL (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DANIEL
Last Name:MULLINS
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 1:7775 JUNK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:OH
Mailing Address - Zip Code:43143-9450
Mailing Address - Country:US
Mailing Address - Phone:740-606-7775
Mailing Address - Fax:
Practice Address - Street 1:109 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-1364
Practice Address - Country:US
Practice Address - Phone:937-981-7133
Practice Address - Fax:937-981-0563
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-24289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist