=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710493507
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN M RICHART PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2017
-----------------------------------------------------
Last Update Date | 12/16/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1730 N GARFIELD AVE
-----------------------------------------------------
City | PIERRE
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57501-5507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-224-8466
-----------------------------------------------------
Fax | 605-224-7936
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1730 N GARFIELD AVE
-----------------------------------------------------
City | PIERRE
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57501-5507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-224-8466
-----------------------------------------------------
Fax | 605-224-7936
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | 6328
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------