Provider Demographics
NPI:1790389682
Name:ROBINSON, MARKITTA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARKITTA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 LAKEBROOKE RUN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3497
Mailing Address - Country:US
Mailing Address - Phone:404-801-6487
Mailing Address - Fax:
Practice Address - Street 1:1144 S INDIAN CREEK DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-5014
Practice Address - Country:US
Practice Address - Phone:404-296-2936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist