Provider Demographics
NPI:1710153945
Name:RICHARDS, MICHAEL D (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:RICHARDS
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 1:201 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2340
Mailing Address - Country:US
Mailing Address - Phone:406-563-8441
Mailing Address - Fax:406-563-2956
Practice Address - Street 1:201 E PARK AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2340
Practice Address - Country:US
Practice Address - Phone:406-563-8441
Practice Address - Fax:406-563-2956
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist