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General NPI Number Information
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NPI Number | 1457981441
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Entity Type | Individual
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Provider Name | GEORGE ELWOOD RICHARDSON III
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Gender | Male
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Dates
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Enumeration Date | 01/19/2020
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Last Update Date | 01/19/2020
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Provider Practice Location Address
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Address Line | 106 MILFORD ST STE 401
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City | SALISBURY
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State | MD
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Zip | 21804-6964
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Country | US
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Telephone | 410-860-0700
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Fax | 410-860-0079
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Provider Business Mailing Address
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Address Line | 15262 RUSSELL DR
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City | ONANCOCK
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State | VA
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Zip | 23417-3004
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Country | US
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Telephone | 410-713-0279
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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 | 9172
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License Number State | MD
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