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Organization

RANDALLS FOOD & DRUGS LP

Active
Other names
TOM THUMB PHARMACY #3575
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
2301 JUSTIN RD, FLOWER MOUND, TX 75028-3777
(972) 539-3222
(972) 539-3427
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-3906

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
22124
TX
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4503288
OTHER ID NUMBER-COMMERCIAL NUMBER
05
464244
TX
Enumeration date
07/06/2006
Last updated
07/05/2024
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