Provider Demographics
NPI:1174951545
Name:RICHARDSON, JOAN CRIBB I (RPH)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:CRIBB
Last Name:RICHARDSON
Suffix:I
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 8TH AVE.
Mailing Address - Street 2:
Mailing Address - City:AYNOR
Mailing Address - State:SC
Mailing Address - Zip Code:29511
Mailing Address - Country:US
Mailing Address - Phone:843-358-2000
Mailing Address - Fax:843-350-2524
Practice Address - Street 1:240 8TH AVE.
Practice Address - Street 2:
Practice Address - City:AYNOR
Practice Address - State:SC
Practice Address - Zip Code:29511
Practice Address - Country:US
Practice Address - Phone:843-358-2000
Practice Address - Fax:843-350-2524
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist