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NPI Code Detail

MEDICARE: MR. PATRICK WILLIE ROBERSON RPH

MEDICARE: MR. PATRICK WILLIE ROBERSON 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
11835P1300XPsychiatric Pharmacist13131LA

General Provider Information

NPI Number : 1164575049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK WILLIE ROBERSON RPH
Provider Business Mailing Address
First Line : 400 EVERGREEN DR
Second Line :
City : DESTREHAN
State : LA
Zip : 70047-5038
Country : US
Telephone Number : 985-764-9595
Fax Number : 504-896-2675
Provider Business Practice Location Address
First Line : 210 STATE ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70118-5735
Country : US
Telephone Number : 504-896-2671
Fax Number : 504-896-2675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 07/08/2007

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