Provider Demographics
NPI:1396036737
Name:ABRAMS, ROBERT LEE
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:ABRAMS
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 1:1029 UNION RD
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-7463
Mailing Address - Country:US
Mailing Address - Phone:828-287-3473
Mailing Address - Fax:
Practice Address - Street 1:555 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-3148
Practice Address - Country:US
Practice Address - Phone:828-652-4343
Practice Address - Fax:828-652-7715
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist