Provider Demographics
NPI:1417119421
Name:HARTWELL, RICHARD CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CRAIG
Last Name:HARTWELL
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 1:10350 ROYAL PALM BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4818
Mailing Address - Country:US
Mailing Address - Phone:954-341-0544
Mailing Address - Fax:954-341-9965
Practice Address - Street 1:10350 ROYAL PALM BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4818
Practice Address - Country:US
Practice Address - Phone:954-341-0544
Practice Address - Fax:954-341-9965
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0021342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist