Provider Demographics
NPI:1477685212
Name:RICHMOND, RODNEY GLENN (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:GLENN
Last Name:RICHMOND
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 1:4686 SHADYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4400
Mailing Address - Country:US
Mailing Address - Phone:304-594-3416
Mailing Address - Fax:304-594-3416
Practice Address - Street 1:4686 SHADYSIDE LN
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4400
Practice Address - Country:US
Practice Address - Phone:304-594-3416
Practice Address - Fax:304-594-3416
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV48991835G0303X
NC90811835G0303X
PARP 039567 R1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric