Healthcare Provider Details

I. General information

NPI: 1821398496
Provider Name (Legal Business Name): KATHY C RICHARD R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 N PARKERSON AVE
CROWLEY LA
70526-3613
US

IV. Provider business mailing address

116 MIDLAND DR
LAFAYETTE LA
70506-5000
US

V. Phone/Fax

Practice location:
  • Phone: 337-785-3102
  • Fax:
Mailing address:
  • Phone: 337-344-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14045
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: