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General NPI Number Information
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NPI Number | 1053396820
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Entity Type | Individual
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Provider Name | ROBERT WILLIAM RIST R.PH.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 280 COHASSET RD
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City | CHICO
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State | CA
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Zip | 95926-2210
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Country | US
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Telephone | 530-879-5000
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Fax | 530-878-5040
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Provider Business Mailing Address
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Address Line | 61 CINDER CONE LP
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City | CHICO
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State | CA
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Zip | 95973-0159
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Country | US
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Telephone | 530-893-1917
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 37139
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License Number State | CA
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