Organization
NELAN LLC
Active
Other names
RANDOLPH MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KUNTAL LALA PHRMD (PHARMACY MANAGER)
(704) 365-0707
Entity
Organization
Contact information
Practice address
3541 RANDOLPH RD, SUITE 104, CHARLOTTE, NC 28211-1082
(704) 365-0707
(704) 442-9870
Mailing address
3541 RANDOLPH RD, SUITE 104, CHARLOTTE, NC 28211-1082
(704) 365-0707
(704) 442-9870
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
09490
NC
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0605998
—
NC
01
—
2068170
PK
—
05
—
7N9490
—
SC
Enumeration date
03/20/2007
Last updated
03/21/2022
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