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General NPI Number Information
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NPI Number | 1528424520
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Entity Type | Individual
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Provider Name | RICHARD CHARLES FORDHAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 3065 DAUPHIN ST
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City | MOBILE
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State | AL
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Zip | 36606-4040
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Country | US
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Telephone | 251-479-9486
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Fax |
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Provider Business Mailing Address
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Address Line | 19780 OGRADY AVE
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City | ROBERTSDALE
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State | AL
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Zip | 36567-8729
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Country | US
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Telephone | 251-947-2248
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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 | 15364
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License Number State | AL
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