Individual
DEJUANA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1619 DELAWARE AVE, MCCOMB, MS 39648-3609
(601) 684-8670
Mailing address
2076 ALBERTA DR, MAGNOLIA, MS 39652-4099
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-15001
MS
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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