Provider Demographics
NPI:1912629247
Name:WEBB, ROBERT LEE JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:WEBB
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 N 157TH LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-4164
Mailing Address - Country:US
Mailing Address - Phone:623-293-0416
Mailing Address - Fax:
Practice Address - Street 1:13828 W WADDELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-3802
Practice Address - Country:US
Practice Address - Phone:623-476-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist