Provider Demographics
NPI:1992118186
Name:PAYNE, ROBERT JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOHN
Last Name:PAYNE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5168 HONPIE RD
Mailing Address - Street 2:PHARMACY SUITE
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-387-8215
Mailing Address - Fax:530-676-4416
Practice Address - Street 1:5168 HONPIE RD
Practice Address - Street 2:PHARMACY SUITE
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667
Practice Address - Country:US
Practice Address - Phone:530-387-8215
Practice Address - Fax:530-676-4416
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist