Provider Demographics
NPI:1023197563
Name:RICHARDS, JOHN CLARKE IV (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLARKE
Last Name:RICHARDS
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2299 MORLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-6935
Mailing Address - Country:US
Mailing Address - Phone:916-359-4815
Mailing Address - Fax:916-359-4816
Practice Address - Street 1:1701 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2104
Practice Address - Country:US
Practice Address - Phone:916-483-3455
Practice Address - Fax:916-483-6745
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist