Provider Demographics
NPI:1417463381
Name:RICHARD, DARICE E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARICE
Middle Name:E
Last Name:RICHARD
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 1:2109 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4307
Mailing Address - Country:US
Mailing Address - Phone:850-528-2051
Mailing Address - Fax:
Practice Address - Street 1:3350 PEACHTREE RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1039
Practice Address - Country:US
Practice Address - Phone:757-490-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST0160011835P0018X
FLPS306801835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist