Provider Demographics
NPI:1619061819
Name:RICHLANDS PHARMACY ASSOCIATES INC
Entity type:Organization
Organization Name:RICHLANDS PHARMACY ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:276-964-9095
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:RAVEN
Mailing Address - State:VA
Mailing Address - Zip Code:24639-0218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:419 RAVEN RD
Practice Address - Street 2:
Practice Address - City:RAVEN
Practice Address - State:VA
Practice Address - Zip Code:24639
Practice Address - Country:US
Practice Address - Phone:276-964-9095
Practice Address - Fax:276-963-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201000683333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4808400OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4808400OtherOTHER ID NUMBER-COMMERCIAL NUMBER