Provider Demographics
NPI:1982987988
Name:ROBINSON, ANDREA SAMPLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SAMPLE
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 1:1560 MONTCLAIR RD
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2230
Mailing Address - Country:US
Mailing Address - Phone:205-595-4588
Mailing Address - Fax:205-595-8355
Practice Address - Street 1:1560 MONTCLAIR RD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-2230
Practice Address - Country:US
Practice Address - Phone:205-595-4588
Practice Address - Fax:205-595-8355
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist