Provider Information for 1982633947
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RANDALLS FOOD & DRUGS LP
Other Names:Doing Business As:TOM THUMB PHARMACY #1784Organization Subpart: NO
NPI: 1982633947
Last Updated: 2024-06-12
Certification Date: 2024-06-12
Certification Date: 2024-06-12
Details
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NPI | 1982633947 | ||||||||||||||||
Enumeration Date | 2006-07-02 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: KATHY GIANNAKOPOULOS Title: Enrollments Manager Phone: 2083953954 | ||||||||||||||||
Mailing Address | 250 E PARKCENTER BLVD BOISE, ID 83706-3940 United States Phone: | Fax: | ||||||||||||||||
Primary Practice Address | 1501 PIONEER RD MESQUITE, TX 75149-6032 United States Phone: 972-290-3358 | Fax:972-290-3371 | ||||||||||||||||
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