Healthcare Provider Details

I. General information

NPI: 1609470566
Provider Name (Legal Business Name): LAURA ELIZABETH RICHARDSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 S PATTERSON BLVD STE 110
DAYTON OH
45402-2643
US

IV. Provider business mailing address

1222 S PATTERSON BLVD STE 110
DAYTON OH
45402-2643
US

V. Phone/Fax

Practice location:
  • Phone: 937-424-1440
  • Fax: 937-608-9450
Mailing address:
  • Phone: 937-424-1440
  • Fax: 937-608-9450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03135768
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: