Healthcare Provider Details

I. General information

NPI: 1699165548
Provider Name (Legal Business Name): TIM ROBINSON PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST BI-2101
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1120 15TH ST BI-2101
AUGUSTA GA
30912-0004
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-4815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH023842
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number013690
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: