Provider Demographics
NPI:1235127366
Name:RANDY'S HELEN PHARMACY
Entity Type:Organization
Organization Name:RANDY'S HELEN PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROGUS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-878-0066
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:HELEN
Mailing Address - State:GA
Mailing Address - Zip Code:30545-0339
Mailing Address - Country:US
Mailing Address - Phone:706-878-0066
Mailing Address - Fax:706-878-1426
Practice Address - Street 1:8016 S MAIN ST
Practice Address - Street 2:SUITE A-1
Practice Address - City:HELEN
Practice Address - State:GA
Practice Address - Zip Code:30545-3620
Practice Address - Country:US
Practice Address - Phone:706-878-0066
Practice Address - Fax:706-878-1426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE 008830333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1151961OtherNABP#
GA1151961OtherNABP#