Provider Demographics
NPI:1922609593
Name:RICHARDSON, LUKE AARON (PHARM D)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:AARON
Last Name:RICHARDSON
Suffix:
Gender:M
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 1:7054 NEW GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:HONAKER
Mailing Address - State:VA
Mailing Address - Zip Code:24260-6466
Mailing Address - Country:US
Mailing Address - Phone:276-971-7384
Mailing Address - Fax:
Practice Address - Street 1:13320 G.C. PEERY HIGHWAY
Practice Address - Street 2:
Practice Address - City:POUNDING MILL
Practice Address - State:VA
Practice Address - Zip Code:24637
Practice Address - Country:US
Practice Address - Phone:276-593-9139
Practice Address - Fax:276-596-9139
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist