Provider Demographics
NPI:1386776607
Name:MCGAUGHEY, RICHARD M (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:MCGAUGHEY
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:PO BOX 1544
Mailing Address - Street 2:
Mailing Address - City:PAONIA
Mailing Address - State:CO
Mailing Address - Zip Code:81428-8044
Mailing Address - Country:US
Mailing Address - Phone:970-527-3372
Mailing Address - Fax:970-527-4108
Practice Address - Street 1:224 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:PAONIA
Practice Address - State:CO
Practice Address - Zip Code:81428-0029
Practice Address - Country:US
Practice Address - Phone:970-527-4109
Practice Address - Fax:970-527-4108
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11497OtherSTATE LICENSE