Provider Demographics
NPI:1992463798
Name:RICHARD, DAROLYN A (CPHT)
Entity type:Individual
Prefix:
First Name:DAROLYN
Middle Name:A
Last Name:RICHARD
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 WARWICK ST
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-5235
Mailing Address - Country:US
Mailing Address - Phone:504-515-2085
Mailing Address - Fax:
Practice Address - Street 1:221 WARWICK ST
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5235
Practice Address - Country:US
Practice Address - Phone:504-515-2085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACPT.0101853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy