Provider Demographics
NPI:1932239472
Name:RICHMOND, THERESA MASSEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MASSEY
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 HIGHLAND PARK PL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2486
Mailing Address - Country:US
Mailing Address - Phone:205-980-5565
Mailing Address - Fax:
Practice Address - Street 1:950 22ND ST N
Practice Address - Street 2:STE 590
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-1126
Practice Address - Country:US
Practice Address - Phone:205-458-8575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist