Provider Demographics
NPI:1194706929
Name:RICHARDS, CALITA S (PHARMD, MPH)
Entity type:Individual
Prefix:DR
First Name:CALITA
Middle Name:S
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PHARMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PIEDMONT AVE NE
Mailing Address - Street 2:UNIT # 807
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3780
Mailing Address - Country:US
Mailing Address - Phone:404-607-7562
Mailing Address - Fax:
Practice Address - Street 1:GEORGIA DIVISION OF PUBLIC HEALTH
Practice Address - Street 2:2 PEACHTREE ST., NW, SUITE 13-222
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3142
Practice Address - Country:US
Practice Address - Phone:404-463-0796
Practice Address - Fax:404-463-2733
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015881183500000X
SC006627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist