Provider Demographics
NPI:1952165581
Name:GILLILAND, ROBERT (PHARMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GILLILAND
Suffix:
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 1:63 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947-1460
Mailing Address - Country:US
Mailing Address - Phone:570-297-5400
Mailing Address - Fax:570-297-5401
Practice Address - Street 1:63 CANTON ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-1460
Practice Address - Country:US
Practice Address - Phone:570-297-5400
Practice Address - Fax:570-297-5401
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist