Provider Demographics
NPI:1902059520
Name:RICHARDS, STEPHEN R (PHARMACIST RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:R
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:PHARMACIST RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 E STATE ST
Mailing Address - Street 2:TOPS PHARMACY 364
Mailing Address - City:SHERRILL
Mailing Address - State:NY
Mailing Address - Zip Code:13461-1231
Mailing Address - Country:US
Mailing Address - Phone:315-361-4090
Mailing Address - Fax:315-361-4969
Practice Address - Street 1:87 E STATE ST
Practice Address - Street 2:TOPS PHARMACY 364
Practice Address - City:SHERRILL
Practice Address - State:NY
Practice Address - Zip Code:13461-1231
Practice Address - Country:US
Practice Address - Phone:315-361-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034522183500000X
NY034522-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist