Logan Randolph

Pharmacist · Poplar Bluff, MO

Individual Active NPI

NPI number 1215537758

Practice location

333 S Westwood Blvd
Poplar Bluff, MO 63901-5519
Phone
(573) 686-6539

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NPI record

NPI
1215537758
Entity type
Individual (Type 1)
Enumeration date
October 26, 2020
Last updated
October 26, 2020
Certified
October 26, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X 2016020572 MO

Mailing address

976 Sunny Valley Ln
Poplar Bluff, MO 63901-6679
Phone
(573) 944-1691

About Logan Randolph

Logan Randolph is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 333 S Westwood Blvd, Poplar Bluff, MO 63901-5519. The NPI number 1215537758 was assigned on October 26, 2020 and the record was last updated on October 26, 2020.

Logan Randolph lists a license in the registry: #2016020572 (MO) for Pharmacist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Logan Randolph?

The NPI number is 1215537758.

What is the phone number of Logan Randolph?

The phone number listed for the practice location is (573) 686-6539.

Where is Logan Randolph located?

333 S Westwood Blvd, Poplar Bluff, MO 63901-5519.

What is the taxonomy code for Logan Randolph?

The primary taxonomy code is 183500000X – Pharmacist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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