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NPI Code Detail

MEDICARE: MR. RICHARD SAMUEL PIEDMONT PHARMACIST

MEDICARE:  MR. RICHARD SAMUEL PIEDMONT  PHARMACIST
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
1183500000XPharmacist15330NV

General Provider Information

NPI Number : 1881810968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD SAMUEL PIEDMONT PHARMACIST
Provider Business Mailing Address
First Line : 389 SILVERADO PINES AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-3575
Country : US
Telephone Number : 702-451-9292
Fax Number :
Provider Business Practice Location Address
First Line : 4855 BOULDER HWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3012
Country : US
Telephone Number : 702-898-5264
Fax Number : 702-898-5274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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Directions to “ MR. RICHARD SAMUEL PIEDMONT PHARMACIST” Practice Location

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