Healthcare Provider Details

I. General information

NPI: 1386607299
Provider Name (Legal Business Name): RICHARD DAVID NORRIS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 FALL ST
SENECA FALLS NY
13148-1408
US

IV. Provider business mailing address

33 CLYDE RD
LYONS NY
14489-9364
US

V. Phone/Fax

Practice location:
  • Phone: 315-568-1700
  • Fax: 315-568-1300
Mailing address:
  • Phone: 315-946-9235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number046851
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: