Provider Demographics
NPI:1821856725
Name:ROBINSON, DARION DONTE
Entity Type:Individual
Prefix:
First Name:DARION
Middle Name:DONTE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 MCKELVEY RD STE L
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2556
Mailing Address - Country:US
Mailing Address - Phone:636-206-6154
Mailing Address - Fax:
Practice Address - Street 1:3430 MCKELVEY RD STE L
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2556
Practice Address - Country:US
Practice Address - Phone:636-206-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies