Doctor Name: | MR. RICHARD GRANDVILLE MICHAEL |
NPI Number: | 1194087478 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RPH |
License Number: | 042027 |
Business Practice Address: | 1311 Woodcastle Rd Nixa, MO - 657147183 |
Business Phone Number: | 4177259302 |
Business Fax Number: | |
Mailing Address: | 1311 Woodcastle Rd, NIXA |
State: | MO |
Postal Code: | 657147183 |
Phone Number: | 4177259302 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2012 |
NPI Last Update Date: | 06/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1835G0303X |
License Number: | 042027 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacist |
Taxonomy Specialization: | Geriatric |
Taxonomy Definition: | A pharmacist who is certified in geriatric pharmacy practice is designated as a |