MEDICARE: MR. DON KEITH RICHIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	12219	GA

General Provider Information

NPI Number	:	1235404542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DON KEITH RICHIE

Provider Business Mailing Address
First Line	:	12718 LAKE JOVITA BLVD
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-8265
Country	:	US
Telephone Number	:	352-588-4269
Fax Number	:

Provider Business Practice Location Address
First Line	:	12210 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-9211
Country	:	US
Telephone Number	:	813-972-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2012
Last Update Date	:	03/20/2012

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Directions to “ MR. DON KEITH RICHIE ” Practice Location

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