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General NPI Number Information
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NPI Number | 1962709717
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Entity Type | Individual
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Provider Name | ALFONSO GOMEZ ROBINSON R.PH.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 801 E LAKESHORE DR
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City | TUSKEGEE
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State | AL
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Zip | 36083-1934
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Country | US
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Telephone | 334-727-0479
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Fax |
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Provider Business Mailing Address
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Address Line | 801 EAST LAKESHORE DRIVE
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City | TUSKEGEE
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State | AL
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Zip | 36083
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Country | US
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Telephone | 334-727-0479
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 10783
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License Number State | AL
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