Provider Demographics
NPI:1821378456
Name:TALLENT, ROBERT D (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:TALLENT
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 1:503 NEWBURY NECK RD
Mailing Address - Street 2:
Mailing Address - City:SURRY
Mailing Address - State:ME
Mailing Address - Zip Code:04684-3706
Mailing Address - Country:US
Mailing Address - Phone:207-266-4244
Mailing Address - Fax:
Practice Address - Street 1:503 NEWBURY NECK RD
Practice Address - Street 2:
Practice Address - City:SURRY
Practice Address - State:ME
Practice Address - Zip Code:04684-3706
Practice Address - Country:US
Practice Address - Phone:207-460-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist