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General NPI Number Information
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NPI Number | 1972897114
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Entity Type | Organization
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Legal Business Name | DR STUART E RICHARDSON, INC
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Dates
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Enumeration Date | 06/06/2011
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Last Update Date | 06/06/2011
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Provider Practice Location Address
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Address Line | 445 S MAINE ST
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City | FALLON
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State | NV
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Zip | 89406-3305
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Country | US
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Telephone | 775-423-4334
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Fax | 775-423-1184
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Provider Business Mailing Address
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Address Line | 445 S MAINE ST
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City | FALLON
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State | NV
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Zip | 89406-3305
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Country | US
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Telephone | 775-423-4334
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Fax | 775-423-1184
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STUART E RICHARDSON
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Credential | O.D.
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Telephone | 775-423-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 176
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License Number State | NV
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