Organization
RANDALLS FOOD & DRUGS LP
Active
Other names
RANDALLS PHARMACY #3145
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
3441 LAKELINE BLVD, LEANDER, TX 78641-5007
(713) 268-3861
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31059
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164297
PK
—
Enumeration date
09/22/2016
Last updated
10/08/2018
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