Provider Demographics
NPI:1154636181
Name:HELMSTUTLER, RICHARD GERALD (RPH)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:GERALD
Last Name:HELMSTUTLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4813 W MERCURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3727
Mailing Address - Country:US
Mailing Address - Phone:757-826-2792
Mailing Address - Fax:757-827-6350
Practice Address - Street 1:4813 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3727
Practice Address - Country:US
Practice Address - Phone:757-826-2792
Practice Address - Fax:757-827-6350
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist