Healthcare Provider Details

I. General information

NPI: 1154758407
Provider Name (Legal Business Name): ROBERT OLOROSO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 TAHOE BLVD
INCLINE VILLAGE NV
89451-9451
US

IV. Provider business mailing address

930 TAHOE BLVD
INCLINE VILLAGE NV
89451-9451
US

V. Phone/Fax

Practice location:
  • Phone: 775-831-3111
  • Fax: 775-831-9116
Mailing address:
  • Phone: 775-831-3111
  • Fax: 775-831-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18178
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: