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General NPI Number Information
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NPI Number | 1326356882
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Entity Type | Individual
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Provider Name | ROBIN FREY R.PH.
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Gender | Female
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 8912 NORTHWEST DR
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City | SOUTHAVEN
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State | MS
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Zip | 38671-2414
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Country | US
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Telephone | 662-393-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 3818 ROSS RIDGE DR
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-7367
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Country | US
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Telephone | 901-212-6112
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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 | 8302
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8646
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License Number State | TN
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