Healthcare Provider Details

I. General information

NPI: 1164974226
Provider Name (Legal Business Name): ROBB SAUNDERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 W 2ND ST
ELMIRA NY
14901-2729
US

IV. Provider business mailing address

2763 FOREST HILL DR
CORNING NY
14830-3690
US

V. Phone/Fax

Practice location:
  • Phone: 607-733-5202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number062047
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: