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NPI Code Detail

MEDICARE: JEFFREY SHANE ROBINSON

MEDICARE:   JEFFREY SHANE ROBINSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26018665AIN

General Provider Information

NPI Number : 1508143025
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY SHANE ROBINSON
Provider Business Mailing Address
First Line : 1156 PREAKNESS DR
Second Line :
City : AVON
State : IN
Zip : 46123-8347
Country : US
Telephone Number : 317-509-4551
Fax Number :
Provider Business Practice Location Address
First Line : 1650 E RAYMOND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-4143
Country : US
Telephone Number : 317-784-7979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2011
Last Update Date : 11/11/2011

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Directions to “ JEFFREY SHANE ROBINSON ” Practice Location

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