Healthcare Provider Details

I. General information

NPI: 1477659712
Provider Name (Legal Business Name): ROBERT THOMAS MCBRIDE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 FRANKLIN ST
TORONTO OH
43964-1949
US

IV. Provider business mailing address

9495 S YUMA TRL
NEGLEY OH
44441-9721
US

V. Phone/Fax

Practice location:
  • Phone: 740-537-9425
  • Fax:
Mailing address:
  • Phone: 330-227-2032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-16653
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: