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General NPI Number Information
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NPI Number | 1578377743
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Entity Type | Individual
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Provider Name | GINA RICHARDSON PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 500 E COLLIN RAYE DR
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City | DE QUEEN
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State | AR
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Zip | 71832-8048
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Country | US
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Telephone | 870-642-5680
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Fax | 870-642-5683
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Provider Business Mailing Address
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Address Line | 577 POLK ROAD 252
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City | GRANNIS
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State | AR
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Zip | 71944-9401
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Country | US
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Telephone | 479-216-0168
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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 | AR10790
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License Number State | AR
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