Provider Demographics
NPI:1174779912
Name:ROBERTSON, BELINDA SUE (RPH)
Entity type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:SUE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9294 STATE ROUTE 249
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:OH
Mailing Address - Zip Code:43517-9556
Mailing Address - Country:US
Mailing Address - Phone:419-658-2232
Mailing Address - Fax:419-633-9272
Practice Address - Street 1:9294 STATE ROUTE 249
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:OH
Practice Address - Zip Code:43517-9556
Practice Address - Country:US
Practice Address - Phone:419-658-2232
Practice Address - Fax:419-633-9272
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-13362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist