Provider Demographics
NPI:1295047538
Name:TREPANIER, RICHARD ALAIN (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAIN
Last Name:TREPANIER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-6431
Mailing Address - Country:US
Mailing Address - Phone:520-586-1299
Mailing Address - Fax:520-586-1293
Practice Address - Street 1:795 W 4TH ST
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602-6431
Practice Address - Country:US
Practice Address - Phone:520-586-1299
Practice Address - Fax:520-586-1293
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS010653183500000X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear