Provider Demographics
NPI:1972103893
Name:HESS, RICHARD L
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:HESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15620 N AMITY ST
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-8101
Mailing Address - Country:US
Mailing Address - Phone:816-532-8276
Mailing Address - Fax:
Practice Address - Street 1:10300 E 350 HWY
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-1803
Practice Address - Country:US
Practice Address - Phone:816-358-0089
Practice Address - Fax:816-358-7978
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO041650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist