Provider Demographics
NPI:1972712495
Name:PAGE, ROBERT CHESTER (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHESTER
Last Name:PAGE
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 1:9033 BULAVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:BIDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:45614-9439
Mailing Address - Country:US
Mailing Address - Phone:740-367-5035
Mailing Address - Fax:
Practice Address - Street 1:204 2ND AVE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1022
Practice Address - Country:US
Practice Address - Phone:740-441-0781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-10059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH194819221918Medicare UPIN