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NPI Code Detail

MEDICARE: MARY K ROBOTHAM RPH, PHARMD

MEDICARE:   MARY K ROBOTHAM  RPH, PHARMD
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
1183500000XPharmacist09373CT

General Provider Information

NPI Number : 1417234352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY K ROBOTHAM RPH, PHARMD
Provider Business Mailing Address
First Line : 475 HARTFORD RD
Second Line :
City : NEW BRITAIN
State : CT
Zip : 06053-1524
Country : US
Telephone Number : 860-348-9163
Fax Number : 860-348-9163
Provider Business Practice Location Address
First Line : 475 HARTFORD RD
Second Line :
City : NEW BRITAIN
State : CT
Zip : 06053-1524
Country : US
Telephone Number : 860-348-9163
Fax Number : 860-348-9163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2011
Last Update Date : 11/07/2011

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Directions to “ MARY K ROBOTHAM RPH, PHARMD” Practice Location

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