Provider Demographics
NPI:1891216644
Name:WOODS, RICH
Entity Type:Individual
Prefix:
First Name:RICH
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 BITTERSWEET LN
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-1600
Mailing Address - Country:US
Mailing Address - Phone:563-552-6077
Mailing Address - Fax:
Practice Address - Street 1:201 N 4TH ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:IL
Practice Address - Zip Code:61061-1418
Practice Address - Country:US
Practice Address - Phone:815-732-7340
Practice Address - Fax:815-732-7340
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-02
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy