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General NPI Number Information
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NPI Number | 1033578570
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Entity Type | Individual
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Provider Name | ANTHONY CHASE RICHMOND CPHT
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Gender | Male
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 2802 OUTER DR
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City | MARION
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State | IL
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Zip | 62959-5207
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Country | US
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Telephone | 618-997-2021
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Fax | 618-997-2634
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Provider Business Mailing Address
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Address Line | 2802 OUTER DR
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City | MARION
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State | IL
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Zip | 62959-5207
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Country | US
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Telephone | 618-997-2021
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Fax | 618-997-2634
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 049190323
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License Number State | IL
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