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NPI Code Detail

MEDICARE: MR. ROBERT WOLF RPH

MEDICARE: MR. ROBERT WOLF RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0010693OR

General Provider Information

NPI Number : 1144520222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT WOLF RPH
Provider Business Mailing Address
First Line : 3169 CRATER LAKE HWY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-9179
Country : US
Telephone Number : 541-774-4346
Fax Number :
Provider Business Practice Location Address
First Line : 3169 CRATER LAKE HWY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-9179
Country : US
Telephone Number : 541-774-4346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2010
Last Update Date : 10/23/2010

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