Healthcare Provider Details

I. General information

NPI: 1801978820
Provider Name (Legal Business Name): ROBERT LANCER LESTER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E. MAIN ST.
ELKHORN CITY KY
41522
US

IV. Provider business mailing address

PO BOX 517
ELKHORN CITY KY
41522-0517
US

V. Phone/Fax

Practice location:
  • Phone: 606-754-0221
  • Fax: 606-754-0225
Mailing address:
  • Phone: 606-754-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number011935
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: