Healthcare Provider Details

I. General information

NPI: 1801409156
Provider Name (Legal Business Name): AUSTIN HEATH RICHARDSON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 CHARLESTON AVE
HUNTINGTON WV
25701
US

IV. Provider business mailing address

46 BURNLEA RD
CHARLES TOWN WV
25414-5087
US

V. Phone/Fax

Practice location:
  • Phone: 304-696-7302
  • Fax:
Mailing address:
  • Phone: 304-270-6279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberIN0009747
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: