Robert G Johnson
Individual provider Active NPI Pharmacist · Merrill, WI
NPI 1407199201 · NPPES record last updated Mar 29, 2013
Key facts
- NPI
- 1407199201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 8553 (WI)
- Practice address
- 1021 E Main St
Merrill, WI 54452-2504 - Phone
- (715) 539-2772
- NPI assigned
- Mar 29, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8553 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8553 | WI | Yes |
Addresses
Primary practice location
1021 E Main St
Merrill, WI 54452-2504
Mailing address
N1159 Johnson LN
Merrill, WI 54452-8306
Phone (715) 536-6695
Other providers in Merrill, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.