Provider Demographics
NPI:1952684375
Name:PATE, RICHARD BRADLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRADLEY
Last Name:PATE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-9314
Mailing Address - Country:US
Mailing Address - Phone:205-753-4000
Mailing Address - Fax:205-753-4050
Practice Address - Street 1:72 PLAZA DR
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-9314
Practice Address - Country:US
Practice Address - Phone:205-753-4000
Practice Address - Fax:205-753-4050
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL16235OtherALABAMA LICENSE NUMBER