Healthcare Provider Details

I. General information

NPI: 1588949440
Provider Name (Legal Business Name): RICHARD PLYMEL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3888 VINEVILLE AVE
MACON GA
31204-1865
US

IV. Provider business mailing address

105 BASS PLANTATION DR APT 909
MACON GA
31210-5735
US

V. Phone/Fax

Practice location:
  • Phone: 478-471-6744
  • Fax:
Mailing address:
  • Phone: 770-778-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH026110
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: