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General NPI Number Information
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NPI Number | 1720398670
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Entity Type | Individual
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Provider Name | RICHARD MAHIEU PHARM D
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Gender | Male
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 62 E MILL RD STE B1
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3118
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Country | US
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Telephone | 844-572-7478
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Fax | 888-887-1815
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Provider Business Mailing Address
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Address Line | 62 E MILL RD STE B1
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3118
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Country | US
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Telephone | 844-572-7478
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Fax | 888-887-1815
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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 | PH00066843
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License Number State | WA
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