Provider Demographics
NPI:1700878758
Name:BONHAM-RICHARDSON, MARY CAROL (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CAROL
Last Name:BONHAM-RICHARDSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9698 PAM CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4301
Mailing Address - Country:US
Mailing Address - Phone:513-777-1565
Mailing Address - Fax:
Practice Address - Street 1:9698 PAM CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4301
Practice Address - Country:US
Practice Address - Phone:513-777-1565
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-17425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist