Provider Demographics
NPI:1093025983
Name:RRICHMOND PROFESSIONAL PHARMACY, INC.
Entity Type:Organization
Organization Name:RRICHMOND PROFESSIONAL PHARMACY, INC.
Other - Org Name:RICHMOND PROFESSIONAL PHARMACY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PIC
Authorized Official - Prefix:
Authorized Official - First Name:BRIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOKOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-687-8639
Mailing Address - Street 1:1601 MAIN ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3247
Mailing Address - Country:US
Mailing Address - Phone:281-633-0700
Mailing Address - Fax:281-633-0704
Practice Address - Street 1:1601 MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3230
Practice Address - Country:US
Practice Address - Phone:281-633-0700
Practice Address - Fax:281-633-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5901435OtherNCPDP PROVIDER IDENTIFICATION NUMBER