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General NPI Number Information
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NPI Number | 1649326208
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Entity Type | Organization
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Legal Business Name | 3 ROBERT LLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 306 RANCH ROAD 2900
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City | KINGSLAND
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State | TX
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Zip | 78639-6063
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Country | US
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Telephone | 325-388-4593
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Fax | 325-388-4594
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Provider Business Mailing Address
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Address Line | PO BOX 4
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City | KINGSLAND
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State | TX
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Zip | 78639-0004
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Country | US
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Telephone | 325-388-4593
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Fax | 325-388-4594
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Authorized Official
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Title or Position | OWNER
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Name | TODD HUMPHRIES
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Credential |
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Telephone | 325-388-4593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 27621
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License Number State | TX
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