=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073431417
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD ROBERTSON PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2026
-----------------------------------------------------
Last Update Date | 07/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5755 S HOUGHTON RD
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85747-0236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-420-3151
-----------------------------------------------------
Fax | 520-324-7979
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2522 N INDIAN RUINS RD
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85715-3319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-420-3151
-----------------------------------------------------
Fax | 520-324-7979
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | S021924
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------