Provider Demographics
NPI:1093113813
Name:RICHARDSON, CARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 6TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4700
Mailing Address - Country:US
Mailing Address - Phone:319-363-0219
Mailing Address - Fax:319-363-8317
Practice Address - Street 1:1520 6TH ST SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4700
Practice Address - Country:US
Practice Address - Phone:319-363-0219
Practice Address - Fax:319-363-8317
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist