Healthcare Provider Details

I. General information

NPI: 1861609257
Provider Name (Legal Business Name): ROBERT BRENT OSBORNE PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2587 NEW KENT HWY
QUINTON VA
23141-1735
US

IV. Provider business mailing address

8275 CARROLTON RIDGE PL
MECHANICSVILLE VA
23111-6525
US

V. Phone/Fax

Practice location:
  • Phone: 804-932-4336
  • Fax:
Mailing address:
  • Phone: 804-932-4336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202207220
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: