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NPI Code Detail

MEDICARE: VICKY RICHARDS DPH

MEDICARE:   VICKY  RICHARDS  DPH
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
1183500000XPharmacist5572TN

General Provider Information

NPI Number : 1245253087
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKY RICHARDS DPH
Provider Business Mailing Address
First Line : 655 E PARK ST
Second Line :
City : ALAMO
State : TN
Zip : 38001-1406
Country : US
Telephone Number : 731-696-3002
Fax Number : 731-663-2792
Provider Business Practice Location Address
First Line : 150 HERNDON DR
Second Line :
City : BELLS
State : TN
Zip : 38006-3659
Country : US
Telephone Number : 731-663-2314
Fax Number : 731-663-2792
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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Directions to “ VICKY RICHARDS DPH” Practice Location

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