Provider Demographics
NPI:1447454822
Name:DISSINGER, ROBERT GEORGE (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GEORGE
Last Name:DISSINGER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:17502-9430
Mailing Address - Country:US
Mailing Address - Phone:717-367-8652
Mailing Address - Fax:
Practice Address - Street 1:200 ANTRIM WAY
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225
Practice Address - Country:US
Practice Address - Phone:717-597-4617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028009L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist