Healthcare Provider Details

I. General information

NPI: 1588136162
Provider Name (Legal Business Name): RICHARD L LEMONS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 12/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E 5TH ST
WASHINGTON MO
63090-3127
US

IV. Provider business mailing address

101 HILLTOP CT
WASHINGTON MO
63090-6205
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-8777
  • Fax:
Mailing address:
  • Phone: 636-283-3887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number040848
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: