Provider Demographics
NPI:1467700690
Name:RICHE, LEO GERARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEO
Middle Name:GERARD
Last Name:RICHE
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 1:131 HIDDEN PATH DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-2202
Mailing Address - Country:US
Mailing Address - Phone:318-729-9174
Mailing Address - Fax:
Practice Address - Street 1:131 HIDDEN PATH DR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-2202
Practice Address - Country:US
Practice Address - Phone:318-729-9174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist