Provider Demographics
NPI:1982989026
Name:WARNOCK, ROBERT RANDAL (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RANDAL
Last Name:WARNOCK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 RIVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621-6121
Mailing Address - Country:US
Mailing Address - Phone:770-880-6901
Mailing Address - Fax:479-478-2459
Practice Address - Street 1:1060 RIVERHILL DR
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:GA
Practice Address - Zip Code:30621-6121
Practice Address - Country:US
Practice Address - Phone:770-880-6901
Practice Address - Fax:479-478-2459
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA126481835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric