Provider Demographics
NPI:1639628969
Name:RICHARDS, ASHLEE (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:ASHLEE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-1628
Mailing Address - Country:US
Mailing Address - Phone:218-773-0611
Mailing Address - Fax:
Practice Address - Street 1:224 14TH ST NE
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721-1628
Practice Address - Country:US
Practice Address - Phone:218-773-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122855183500000X
NDRPH5872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist