Provider Demographics
NPI:1316061419
Name:ROBINETTE, THOMAS LEE (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LEE
Last Name:ROBINETTE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 FREDERICK DR
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1505
Mailing Address - Country:US
Mailing Address - Phone:304-776-5760
Mailing Address - Fax:304-776-2392
Practice Address - Street 1:5203 FREDERICK DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1505
Practice Address - Country:US
Practice Address - Phone:304-776-5760
Practice Address - Fax:304-776-2392
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0002822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist