Healthcare Provider Details

I. General information

NPI: 1134418262
Provider Name (Legal Business Name): ROBYN PROGAR RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 WYTHE CREEK RD
POQUOSON VA
23662-1915
US

IV. Provider business mailing address

206 JESSICA DR
YORKTOWN VA
23693-1911
US

V. Phone/Fax

Practice location:
  • Phone: 757-868-0297
  • Fax:
Mailing address:
  • Phone: 757-867-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202009728
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: