Organization
RANDALLS FOOD & DRUGS LP
Active
Other names
TOM THUMB PHARMACY #2963
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
5550 F.M. 423, FRISCO, TX 75036-8900
(214) 494-6226
(214) 494-6231
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
28547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
466939
—
CA
01
—
5909467
NCPDP
—
Enumeration date
08/20/2013
Last updated
11/27/2018
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