Provider Demographics
NPI:1760416853
Name:ROBINSON, NELL FAULKENBERRY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NELL
Middle Name:FAULKENBERRY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W MARION ST
Mailing Address - Street 2:P.O. BOX 218
Mailing Address - City:KERSHAW
Mailing Address - State:SC
Mailing Address - Zip Code:29067-1412
Mailing Address - Country:US
Mailing Address - Phone:803-475-9665
Mailing Address - Fax:803-475-0669
Practice Address - Street 1:203 W MARION ST
Practice Address - Street 2:
Practice Address - City:KERSHAW
Practice Address - State:SC
Practice Address - Zip Code:29067-1412
Practice Address - Country:US
Practice Address - Phone:803-475-9665
Practice Address - Fax:803-475-0669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist