Provider Demographics
NPI:1922314319
Name:MOLE, RICHARD P (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:MOLE
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 1:5 WALKER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240-2723
Mailing Address - Country:US
Mailing Address - Phone:413-637-4700
Mailing Address - Fax:413-637-0366
Practice Address - Street 1:5 WALKER ST STE 1
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2723
Practice Address - Country:US
Practice Address - Phone:413-637-4700
Practice Address - Fax:413-637-0366
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH15360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist