Provider Demographics
NPI:1588949440
Name:PLYMEL, RICHARD (PHARMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:PLYMEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BASS PLANTATION DR
Mailing Address - Street 2:APT 909
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5735
Mailing Address - Country:US
Mailing Address - Phone:770-778-2045
Mailing Address - Fax:
Practice Address - Street 1:3888 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-1865
Practice Address - Country:US
Practice Address - Phone:478-471-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist