Provider Demographics
NPI:1083795140
Name:RICHMOND, AMY MARIE (CPHT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 772
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:VA
Mailing Address - Zip Code:24066-0772
Mailing Address - Country:US
Mailing Address - Phone:540-293-4678
Mailing Address - Fax:540-254-2907
Practice Address - Street 1:19771 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:VA
Practice Address - Zip Code:24066
Practice Address - Country:US
Practice Address - Phone:540-254-2904
Practice Address - Fax:540-254-2907
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230002725183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician