Provider Demographics
NPI:1356776801
Name:KENT, ROBERT LOUIS (PHARM D)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOUIS
Last Name:KENT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PELHAM RD APT 86
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3198
Mailing Address - Country:US
Mailing Address - Phone:864-235-7799
Mailing Address - Fax:
Practice Address - Street 1:2401 E NORTH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-1401
Practice Address - Country:US
Practice Address - Phone:864-244-1851
Practice Address - Fax:864-244-3430
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist