Provider Demographics
NPI:1689895443
Name:ROBITAILLE, PIERRE LEO (RPH)
Entity Type:Individual
Prefix:MR
First Name:PIERRE
Middle Name:LEO
Last Name:ROBITAILLE
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 1:36 DONNA AVENUE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3922
Mailing Address - Country:US
Mailing Address - Phone:603-622-1471
Mailing Address - Fax:
Practice Address - Street 1:6 LOUDON ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:CONCORD
Practice Address - State:HI
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-230-1111
Practice Address - Fax:603-227-7500
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist