Provider Demographics
NPI:1730699588
Name:CRIBBS, PHILIP ANDREW (RPH)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANDREW
Last Name:CRIBBS
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 1:6489 SEDGEFORD DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1834
Mailing Address - Country:US
Mailing Address - Phone:863-397-9109
Mailing Address - Fax:
Practice Address - Street 1:3636 HARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-5938
Practice Address - Country:US
Practice Address - Phone:863-647-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist