Provider Demographics
NPI:1932263464
Name:ROBIE H ROBINSON
Entity Type:Organization
Organization Name:ROBIE H ROBINSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:804-739-4000
Mailing Address - Street 1:6721 LAKE HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2083
Mailing Address - Country:US
Mailing Address - Phone:804-739-4000
Mailing Address - Fax:804-739-5579
Practice Address - Street 1:6721 LAKE HARBOUR DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2083
Practice Address - Country:US
Practice Address - Phone:804-739-4000
Practice Address - Fax:804-739-5579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000115152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V466R43Medicaid
VA00V465R43Medicaid
VA5154560001Medicare NSC
VA00V466R43Medicaid