Healthcare Provider Details

I. General information

NPI: 1326366139
Provider Name (Legal Business Name): ROBERT T POLLOCK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491A BLUE EAGLE AVE
HARRISBURG PA
17112-2314
US

IV. Provider business mailing address

491A BLUE EAGLE AVE
HARRISBURG PA
17112-2314
US

V. Phone/Fax

Practice location:
  • Phone: 717-561-9996
  • Fax: 717-651-9798
Mailing address:
  • Phone: 717-561-9996
  • Fax: 717-651-9798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP027818L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberRP027818L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: