Healthcare Provider Details

I. General information

NPI: 1831181429
Provider Name (Legal Business Name): ROBIN ANNETTE EADDY WHEELER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 N BROAD ST WALGREENS PHARMACY #04115
PHILADELPHIA PA
19140-3019
US

IV. Provider business mailing address

8531 MANSFIELD AVE
PHILADELPHIA PA
19150-3207
US

V. Phone/Fax

Practice location:
  • Phone: 215-457-3877
  • Fax: 215-457-3363
Mailing address:
  • Phone: 215-242-3968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP437862
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: