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General NPI Number Information
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NPI Number | 1083215545
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Entity Type | Individual
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Provider Name | ALICIA K RICHARDSON PHARMD, BSPS, RPH
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Gender | Female
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 485 AIRPORT HWY
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City | WAUSEON
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State | OH
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Zip | 43567-8709
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Country | US
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Telephone | 419-337-8122
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Fax | 419-337-8492
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Provider Business Mailing Address
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Address Line | 15629 COUNTY RD N
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City | NAPOLEON
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State | OH
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Zip | 43545-6702
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Country | US
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Telephone | 419-591-8449
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03234202
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License Number State | OH
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