Provider Demographics
NPI:1437163581
Name:SCHIAVONE, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SCHIAVONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 SOM CENTER RD
Mailing Address - Street 2:KAISER PHARMACY
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4203
Mailing Address - Country:US
Mailing Address - Phone:440-953-5792
Mailing Address - Fax:440-975-4606
Practice Address - Street 1:5105 SOM CENTER RD
Practice Address - Street 2:KAISER PHARMACY
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4203
Practice Address - Country:US
Practice Address - Phone:440-953-5792
Practice Address - Fax:440-975-4606
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-19978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist