Provider Demographics
NPI:1982926846
Name:GEBHARDS, ROBERT M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:GEBHARDS
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 1:6499 FARTHING DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7502
Mailing Address - Country:US
Mailing Address - Phone:719-564-0220
Mailing Address - Fax:
Practice Address - Street 1:1728 S PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2253
Practice Address - Country:US
Practice Address - Phone:719-564-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16896OtherSTATE LICENSE NUMBER