Provider Demographics
NPI:1326038191
Name:ESTES, RICHARD (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ESTES
Suffix:
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 1:5570 FOREST BEND DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-6103
Mailing Address - Country:US
Mailing Address - Phone:937-436-1616
Mailing Address - Fax:937-228-7111
Practice Address - Street 1:32 N LUDLOW ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1826
Practice Address - Country:US
Practice Address - Phone:937-228-9145
Practice Address - Fax:937-228-7111
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-12202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist