Provider Demographics
NPI:1306135249
Name:WOBRAK, ROBERT E JR
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:WOBRAK
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-1124
Mailing Address - Country:US
Mailing Address - Phone:717-786-9091
Mailing Address - Fax:717-806-0988
Practice Address - Street 1:315 W 4TH ST
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-1124
Practice Address - Country:US
Practice Address - Phone:717-786-9091
Practice Address - Fax:717-806-0988
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031390L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist