Richard Delorenzo, PHARMD

Individual provider Active NPI Pharmacist · St Simons Island, GA

NPI 1467829630 · NPPES record last updated Aug 24, 2015

Key facts

NPI
1467829630
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RPH028773 (GA)
Practice address
220 Retreat VLG
St Simons Island, GA 31522-2403
Phone
(912) 634-4817
NPI assigned
Aug 24, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH028773GAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH028773 GA Yes

Addresses

Primary practice location

220 Retreat VLG
St Simons Island, GA 31522-2403

Mailing address

23 White Oak CT
Brunswick, GA 31520-2215
Phone (912) 577-2345

Other providers in St Simons Island, GA

All providers in St Simons Island, GA · Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.