Healthcare Provider Details

I. General information

NPI: 1619420841
Provider Name (Legal Business Name): DAVID RYCHLY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2016
Last Update Date: 07/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 WRIGHTSBORO RD
AUGUSTA GA
30909-2518
US

IV. Provider business mailing address

3435 WRIGHTSBORO RD
AUGUSTA GA
30909-2518
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-7352
  • Fax: 706-667-8326
Mailing address:
  • Phone: 706-733-7352
  • Fax: 706-667-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22553
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: