Provider Demographics
NPI:1316634884
Name:MILLS, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MILLS
Suffix:
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:PO BOX 26602
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35260-0602
Mailing Address - Country:US
Mailing Address - Phone:205-223-4704
Mailing Address - Fax:
Practice Address - Street 1:186 OLD HIGHWAY 431
Practice Address - Street 2:SUITE A
Practice Address - City:HAMPTON COVE
Practice Address - State:AL
Practice Address - Zip Code:35763
Practice Address - Country:US
Practice Address - Phone:205-223-4704
Practice Address - Fax:256-469-7961
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist