Provider Demographics
NPI:1235675224
Name:RICHARDS, WILLIAM WARREN
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WARREN
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:WARREN
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:5226 SIGMON RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1666
Mailing Address - Country:US
Mailing Address - Phone:910-392-2945
Mailing Address - Fax:910-792-1765
Practice Address - Street 1:5226 SIGMON RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1666
Practice Address - Country:US
Practice Address - Phone:910-392-2945
Practice Address - Fax:910-792-1765
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist