Individual
MR. RANDOLPH PATRICK POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
7776 WINGHAVEN BLVD, O FALLON, MO 63368-3601
(636) 265-2924
(636) 265-2927
Mailing address
1709 DAVINCI DR, O FALLON, MO 63368-6836
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043672
MO
1835N1003X
Nutrition Support Pharmacist
043672
MO
Other
Enumeration date
04/10/2013
Last updated
08/16/2013
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