1194706929 NPI number — DR. CALITA S. RICHARDS PHARM.D., M.P.H.

Table of content: DR. CALITA S. RICHARDS PHARM.D., M.P.H. (NPI 1194706929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194706929 NPI number — DR. CALITA S. RICHARDS PHARM.D., M.P.H.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARDS
Provider First Name:
CALITA
Provider Middle Name:
S.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D., M.P.H.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194706929
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1130 PIEDMONT AVE NE
Provider Second Line Business Mailing Address:
UNIT # 807
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30309-3780
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-607-7562
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GEORGIA DIVISION OF PUBLIC HEALTH
Provider Second Line Business Practice Location Address:
2 PEACHTREE ST., NW, SUITE 13-222
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30303-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-463-0796
Provider Business Practice Location Address Fax Number:
404-463-2733
Provider Enumeration Date:
11/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  015881 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 006627 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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