Provider Demographics
NPI:1912142795
Name:PLOUDE, RICHARD KENNETH JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:KENNETH
Last Name:PLOUDE
Suffix:JR
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 1:140 LOCKE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-7230
Mailing Address - Country:US
Mailing Address - Phone:508-573-5200
Mailing Address - Fax:508-490-8560
Practice Address - Street 1:140 LOCKE DR
Practice Address - Street 2:SUITE C
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-7230
Practice Address - Country:US
Practice Address - Phone:508-573-5200
Practice Address - Fax:508-490-8560
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist