Provider Demographics
NPI:1982134607
Name:RICHARDS, UCHENNA JUNIOR
Entity Type:Individual
Prefix:
First Name:UCHENNA
Middle Name:JUNIOR
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 SUMMIT AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7746
Mailing Address - Country:US
Mailing Address - Phone:336-491-8231
Mailing Address - Fax:877-895-1090
Practice Address - Street 1:311 COLLEGE RD UNIT C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5159
Practice Address - Country:US
Practice Address - Phone:919-408-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X, 372600000X, 374U00000X, 376K00000X, 251J00000X, 376K00000X, 172V00000X, 251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
No172V00000XOther Service ProvidersCommunity Health Worker
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization