NPI | 1104855170 |
---|---|
Doing Business As | RANDALLS PHARMACY #2673 |
Entity Type | Organization |
Authorized Contact | TIFFANY ELIOPULOS Assistant Manager, Enrollments 208-395-3906 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 22033) |
Enumeration Date | 2006-07-02 |
Last Update Date | 2018-10-04 |