Active NPI
Richard Foster Broderick
- Ambulatory Care Pharmacist
- Cincinnati, OH
National Provider Identifier
1942804224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 03319920
- Practice address
- 3195 Linwood Ave
Cincinnati, OH 45208-2946 - Phone
- (513) 321-2470
- NPI assigned
- Nov 26, 2020
- Last updated
- Nov 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 03319920 | OH | Primary |
Addresses
Primary practice location
3195 Linwood Ave
Cincinnati, OH 45208-2946
Mailing address
3195 Linwood Ave
Cincinnati, OH 45208-2946
Phone (513) 321-2470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03319920 | OH | MD | Ambulatory Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio CVS Stores LLC | Past | Accepting new patients | |
| Ohio CVS Stores, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1942804224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3195 LINWOOD AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452082946",
"telephone_number": "513-321-2470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3195 LINWOOD AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452082946",
"telephone_number": "513-321-2470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERICK",
"first_name": "RICHARD",
"middle_name": "FOSTER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-26",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "OH",
"license": "03319920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.