Provider Demographics
NPI:1891072252
Name:GARIBAY, RICHARD (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:GARIBAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:MR
Other - First Name:RICARDO
Other - Middle Name:
Other - Last Name:GARIBAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:100 MINGES CREEK PL # 102
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-5716
Mailing Address - Country:US
Mailing Address - Phone:773-680-6190
Mailing Address - Fax:
Practice Address - Street 1:7109 S JEFFERY BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2425
Practice Address - Country:US
Practice Address - Phone:773-568-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist