Individual
DOUGLAS RANDOLPH MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
90 CIC BLVD, WEST UNION, OH 45693-8024
(937) 544-8989
Mailing address
90 CIC BLVD, WEST UNION, OH 45693-8024
(937) 544-8989
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03311666
OH
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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