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NPI Code Detail

MEDICARE: ABBY RICHARDSON

MEDICARE: ABBY RICHARDSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist122429MN

General Provider Information

NPI Number : 1063023240
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBY RICHARDSON
Provider Business Mailing Address
First Line : 2024 85TH AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55444-1495
Country : US
Telephone Number : 763-424-9243
Fax Number : 763-424-9468
Provider Business Practice Location Address
First Line : 2024 85TH AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55444-1495
Country : US
Telephone Number : 763-424-9243
Fax Number : 763-424-9468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2020
Last Update Date : 08/12/2020

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Directions to “ ABBY RICHARDSON ” Practice Location

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