Provider Demographics
NPI:1114067642
Name:FW RICHARDS JR INC
Entity Type:Organization
Organization Name:FW RICHARDS JR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:FLEET
Authorized Official - Middle Name:WILKINSON
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:434-372-3191
Mailing Address - Street 1:932 NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHASE CITY
Mailing Address - State:VA
Mailing Address - Zip Code:23924
Mailing Address - Country:US
Mailing Address - Phone:434-372-3191
Mailing Address - Fax:434-372-2023
Practice Address - Street 1:932 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:CHASE CITY
Practice Address - State:VA
Practice Address - Zip Code:23924
Practice Address - Country:US
Practice Address - Phone:434-372-3191
Practice Address - Fax:434-372-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201001375333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4813211OtherNABP
AR6826664OtherDEA
AR6826664OtherDEA