Organization
RANDALLS FOOD & DRUGS LP
Active
Other names
TOM THUMB PHARMACY #2990
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
7117 INWOOD RD, DALLAS, TX 75209-4803
(214) 350-1992
(214) 902-4850
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
22117
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4568664
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
463773
—
TX
Enumeration date
07/02/2006
Last updated
07/05/2024
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