Provider Demographics
NPI:1235811167
Name:RICHARDS, MARIAH YASMINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:YASMINE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9816 PERIMETER STATION DR APT 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-3335
Mailing Address - Country:US
Mailing Address - Phone:919-945-4587
Mailing Address - Fax:
Practice Address - Street 1:1305 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4600
Practice Address - Country:US
Practice Address - Phone:704-847-8508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist