Provider Demographics
NPI:1942877659
Name:EKIERT, ROBERT (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:EKIERT
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 1:8571 FOXWOOD CT STE A
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-4313
Mailing Address - Country:US
Mailing Address - Phone:330-318-3926
Mailing Address - Fax:330-318-3927
Practice Address - Street 1:20 E LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3826
Practice Address - Country:US
Practice Address - Phone:724-658-8661
Practice Address - Fax:724-658-8684
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043318L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP043318LOtherPA BOARD OF PHARMACY