Individual
MRS. STEPHANIE LINA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
226 PARKER FARM RD, BUXTON, ME 04093-3150
(207) 727-5139
(207) 727-5509
Mailing address
36 FENGLER RD, SCARBOROUGH, ME 04074-8490
(207) 883-2321
(207) 727-5509
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR0004624
ME
183500000X
Pharmacist
PS32623
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109127100
—
FL
01
—
109127101
MEDICAID DME
FL
Enumeration date
09/22/2006
Last updated
08/21/2013
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