Provider Demographics
NPI:1598806309
Name:BOONE, RICHARD LAMAR (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LAMAR
Last Name:BOONE
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 1:310 SOUTH MAIN STREET
Mailing Address - Street 2:POST OFFICE BOX 480999
Mailing Address - City:LINDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36748
Mailing Address - Country:US
Mailing Address - Phone:334-295-4270
Mailing Address - Fax:334-295-0141
Practice Address - Street 1:310 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:AL
Practice Address - Zip Code:36748
Practice Address - Country:US
Practice Address - Phone:334-295-4270
Practice Address - Fax:334-295-0141
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist