Healthcare Provider Details

I. General information

NPI: 1215851746
Provider Name (Legal Business Name): RYLE ROBERTSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

IV. Provider business mailing address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-9000
  • Fax:
Mailing address:
  • Phone: 704-638-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26032195A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: