Organization
KVG ENTERPRISES INC
Active
Other names
RANDOL MILL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GARY DALEY RPH. (PRES./RPH.)
(817) 274-1883
Entity
Organization
Contact information
Practice address
1014 N FIELDER RD, ARLINGTON, TX 76012-3149
(817) 274-1883
Mailing address
1014 N FIELDER RD, ARLINGTON, TX 76012-3149
(817) 274-1883
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
14456
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013926301
—
TX
05
—
078896001
—
TX
05
—
091453301
—
TX
01
—
2099328
PK
—
Enumeration date
09/12/2006
Last updated
08/17/2023
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