Provider Demographics
NPI:1992164123
Name:ROBBINS, DANIEL (PHARM D)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 S HOLLADAY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5403
Mailing Address - Country:US
Mailing Address - Phone:801-278-9767
Mailing Address - Fax:
Practice Address - Street 1:4714 S HOLLADAY BLVD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5403
Practice Address - Country:US
Practice Address - Phone:801-278-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7036814-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist