Richard Kenneth Ingram, RPH
Individual provider Active NPI Pharmacist · Saint Joseph, IL
NPI 1326470410 · NPPES record last updated Jul 31, 2013
Key facts
- NPI
- 1326470410
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051031633 (IL)
- Practice address
- 1372 County Road 2275 E
Saint Joseph, IL 61873-9627 - Phone
- (217) 469-2007
- NPI assigned
- Jul 31, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051031633 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051031633 | IL | Yes |
Addresses
Primary practice location
1372 County Road 2275 E
Saint Joseph, IL 61873-9627
Mailing address
1372 County Road 2275 E
P.O.Box 588
Saint Joseph, IL 61873-9627
Phone (217) 469-2007
Other providers in Saint Joseph, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.