Provider Demographics
NPI:1154640951
Name:PARKER, RICHARD DALE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DALE
Last Name:PARKER
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2320 HONEYSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-3215
Mailing Address - Country:US
Mailing Address - Phone:301-774-9550
Mailing Address - Fax:301-774-9295
Practice Address - Street 1:17340 QUAKER LN
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1247
Practice Address - Country:US
Practice Address - Phone:301-774-2201
Practice Address - Fax:301-774-2202
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist