Provider Demographics
NPI:1992700157
Name:OLSEN, ROBERT STEPHEN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:OLSEN
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 1:780 SELKIRK RD
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-7716
Mailing Address - Country:US
Mailing Address - Phone:208-263-7749
Mailing Address - Fax:208-263-4673
Practice Address - Street 1:780 SELKIRK RD
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-7716
Practice Address - Country:US
Practice Address - Phone:208-263-7749
Practice Address - Fax:208-263-4673
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH29784183500000X
CO13242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist