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MRS. STEPHANIE LINA RANDALL RPH

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1851491773

Individual Registrant:
MRS. STEPHANIE LINA RANDALL RPH
Gender: F
Not Sole Proprietor

Location and contact information for practice:
226 PARKER FARM RD  BUXTON, ME 04093-3150 US
Tel: 207-727-5139  Fax: 207-727-5509

Contact information for business:
36 FENGLER RD  SCARBOROUGH, ME 04074-8490 US
Tel: 207-883-2321  Fax: 207-727-5509

Registration Information:
NPI: 1851491773
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N183500000XPharmacy Service Providers
Pharmacist
FLPS32623
Y183500000XPharmacy Service Providers
Pharmacist
MEPR0004624

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
109127100FL05
MEDICAID DME109127101FL01




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