Provider Demographics
NPI:1891772471
Name:MABE, ROBERT DEAN (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DEAN
Last Name:MABE
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 1:4 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43103
Mailing Address - Country:US
Mailing Address - Phone:740-983-2501
Mailing Address - Fax:740-983-2503
Practice Address - Street 1:4 MAIN ST E
Practice Address - Street 2:
Practice Address - City:ASHVILLE
Practice Address - State:OH
Practice Address - Zip Code:43103-1512
Practice Address - Country:US
Practice Address - Phone:740-983-2501
Practice Address - Fax:740-983-2503
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-09817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist