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Organization

CLEVELAND RANDOLPH, JR, MD, PA

Active
Other names
C.W.Randolph's Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLEVELAND RANDOLPH JR. M.D. (OWNER)
(904) 746-3046
Entity
Organization

Contact information

Practice address
1891 BEACH BLVD, JACKSONVILLE BEACH, FL 32250-2644
(904) 746-3046
(904) 249-2047
Mailing address
1891 BEACH BLVD, JACKSONVILLE BEACH, FL 32250-2644
(904) 746-3046
(904) 249-2047

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH28647
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH28647
PHARMACY LICENSE
FL
Enumeration date
01/13/2015
Last updated
01/13/2015
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