Provider Demographics
NPI:1588057764
Name:UJOODHA, ROBIN B
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:B
Last Name:UJOODHA
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 1:231 CLARE RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1363
Mailing Address - Country:US
Mailing Address - Phone:419-529-2707
Mailing Address - Fax:
Practice Address - Street 1:231 CLARE RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1363
Practice Address - Country:US
Practice Address - Phone:419-529-2707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06216631183500000X
FLPS51693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist