Provider Demographics
NPI:1871765404
Name:ROBINSON, TERESA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 GALLANT FOX DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8033
Mailing Address - Country:US
Mailing Address - Phone:937-935-6285
Mailing Address - Fax:
Practice Address - Street 1:120 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:RUSSELLS POINT
Practice Address - State:OH
Practice Address - Zip Code:43348
Practice Address - Country:US
Practice Address - Phone:937-843-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH32278671835P0018X
OH03-2-27867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist