Provider Demographics
NPI:1992936538
Name:SLAVIN, WILLIAM ROBERT (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:SLAVIN
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 1:114 KEEL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6619
Mailing Address - Country:US
Mailing Address - Phone:704-929-1372
Mailing Address - Fax:
Practice Address - Street 1:1987 COTTON GROVE RD.
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27299
Practice Address - Country:US
Practice Address - Phone:336-357-2396
Practice Address - Fax:336-357-7758
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist