Provider Demographics
NPI:1669795852
Name:GRAHAM, ROBYN F (RPH)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:F
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240-2178
Mailing Address - Country:US
Mailing Address - Phone:413-448-2541
Mailing Address - Fax:
Practice Address - Street 1:489 PITTSFIELD LENOX RD
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2173
Practice Address - Country:US
Practice Address - Phone:413-499-3430
Practice Address - Fax:413-499-7029
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist