Provider Demographics
NPI:1154366854
Name:WALCHLE, RICHARD CHARLES (R PH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CHARLES
Last Name:WALCHLE
Suffix:
Gender:
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3638 CATTAIL DR S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-3289
Mailing Address - Country:US
Mailing Address - Phone:904-292-0311
Mailing Address - Fax:904-292-0511
Practice Address - Street 1:11401 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-1402
Practice Address - Country:US
Practice Address - Phone:904-886-8447
Practice Address - Fax:904-886-7764
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist