Provider Demographics
NPI:1861139578
Name:ROBERT, EMILY (STUDENT PHARMACIST)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ROBERT
Suffix:
Gender:F
Credentials:STUDENT PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 NORTHEAST EXPY NE APT S06
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1874 PIEDMONT AVE NE STE 100A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4816
Practice Address - Country:US
Practice Address - Phone:404-733-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-14
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1605684OtherNABP