MEDICARE: MRS. MICHELE LEE ROBINSON R.PH.

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
1	183500000X	Pharmacist	11662-40	WI

General Provider Information

NPI Number	:	1811281769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELE LEE ROBINSON R.PH.

Provider Business Mailing Address
First Line	:	9777 76TH ST
Second Line	:	T-2251
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1990
Country	:	US
Telephone Number	:	262-842-1171
Fax Number	:	262-842-1181

Provider Business Practice Location Address
First Line	:	9777 76TH ST
Second Line	:	T-2251
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1990
Country	:	US
Telephone Number	:	262-842-1171
Fax Number	:	262-842-1181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	06/07/2011

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