Provider Demographics
NPI:1609593425
Name:TOWNSEND, RICKY CHARLES (RPH)
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:CHARLES
Last Name:TOWNSEND
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 1:3824 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-4718
Mailing Address - Country:US
Mailing Address - Phone:765-640-4398
Mailing Address - Fax:
Practice Address - Street 1:3824 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-4718
Practice Address - Country:US
Practice Address - Phone:765-640-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015056A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist