Provider Demographics
NPI:1922317015
Name:FERGUSON, ROBERT D (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:D
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7221 E SIENNA SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-1455
Mailing Address - Country:US
Mailing Address - Phone:928-772-3486
Mailing Address - Fax:
Practice Address - Street 1:7221 E SIENNA SPRINGS LN
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1455
Practice Address - Country:US
Practice Address - Phone:928-772-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist