Provider Demographics
NPI:1093209876
Name:RANDA, ERIN RENAE (PHARM D)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RENAE
Last Name:RANDA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:RENAE
Other - Last Name:SEIFERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:4417 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5618
Mailing Address - Country:US
Mailing Address - Phone:970-481-1061
Mailing Address - Fax:
Practice Address - Street 1:302 3RD ST SE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-6419
Practice Address - Country:US
Practice Address - Phone:970-461-3843
Practice Address - Fax:970-461-3847
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist