Individual
BRENT ADAM ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 E 2ND ST, OIL CITY, PA 16301-2321
(814) 677-4007
Mailing address
204 E 2ND ST, OIL CITY, PA 16301-2321
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP441900
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03331269
PHARMACY LICENSE
OH
01
—
RP441900
PHARMACY LICENSE
PA
Enumeration date
12/01/2020
Last updated
12/01/2020
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