| Doctor Name: | RICHARD EARL MINTER |
| NPI Number: | 1518036979 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | R4F20 |
| Business Practice Address: | 505 E Grant St Ste 202 Macomb, IL - 614553373 |
| Business Phone Number: | 3098331729 |
| Business Fax Number: | |
| Mailing Address: | 505 E Grant St Ste 202, MACOMB |
| State: | IL |
| Postal Code: | 614553373 |
| Phone Number: | 3098331729 |
| Fax Number: | |
| NPI Enumeration Date: | 11/07/2006 |
| NPI Last Update Date: | 01/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 333600000X |
| License Number: | R4F20 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |