Provider Demographics
NPI:1154629871
Name:RICHMAN, WILLIAM JEFFERSON II (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JEFFERSON
Last Name:RICHMAN
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-1640
Mailing Address - Country:US
Mailing Address - Phone:304-822-3313
Mailing Address - Fax:304-822-3908
Practice Address - Street 1:150 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1640
Practice Address - Country:US
Practice Address - Phone:304-822-3313
Practice Address - Fax:304-822-3908
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist