Provider Demographics
NPI:1912520602
Name:ROBINSON, MEGAN ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STEELE
Mailing Address - State:MO
Mailing Address - Zip Code:63877-1434
Mailing Address - Country:US
Mailing Address - Phone:573-695-4533
Mailing Address - Fax:573-695-3327
Practice Address - Street 1:128 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STEELE
Practice Address - State:MO
Practice Address - Zip Code:63877-1434
Practice Address - Country:US
Practice Address - Phone:573-695-4533
Practice Address - Fax:573-695-3327
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015022713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1285734954Medicaid