Provider Demographics
NPI:1932383049
Name:ROBBINS, TIM A (PHARMD)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:A
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 GRAPEVINE CIR
Mailing Address - Street 2:
Mailing Address - City:GASSAWAY
Mailing Address - State:WV
Mailing Address - Zip Code:26624-9355
Mailing Address - Country:US
Mailing Address - Phone:304-364-5636
Mailing Address - Fax:
Practice Address - Street 1:105 DUNCAN ROAD
Practice Address - Street 2:
Practice Address - City:MARLINTON
Practice Address - State:WV
Practice Address - Zip Code:26624
Practice Address - Country:US
Practice Address - Phone:304-799-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist