Provider Demographics
NPI:1346580149
Name:ALTER, RICHARD ANDREW
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ANDREW
Last Name:ALTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 EAST MARION AVENUE
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950
Mailing Address - Country:US
Mailing Address - Phone:941-637-3115
Mailing Address - Fax:941-637-2565
Practice Address - Street 1:809 E MARION AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3819
Practice Address - Country:US
Practice Address - Phone:941-637-3115
Practice Address - Fax:941-637-2565
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist