Healthcare Provider Details

I. General information

NPI: 1891850111
Provider Name (Legal Business Name): ROBERT H SEIWERT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 PROFESSIONAL DR STE 150
AUBURN CA
95603-2410
US

IV. Provider business mailing address

3126 PROFESSIONAL DR STE 150
AUBURN CA
95603-2410
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-9970
  • Fax: 530-889-9975
Mailing address:
  • Phone: 530-889-9970
  • Fax: 530-889-9975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY45200
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY SCHOPF
Title or Position: MANAGER
Credential:
Phone: 530-889-9970