Provider Demographics
NPI:1417042383
Name:LANIER, RANDI RANAE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:RANDI
Middle Name:RANAE
Last Name:LANIER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 FOOTHILL DR
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953
Mailing Address - Country:US
Mailing Address - Phone:918-647-4150
Mailing Address - Fax:918-567-7037
Practice Address - Street 1:CHOCTAW NATION HEALTH CARE CENTER
Practice Address - Street 2:ONE CHOCTAW WAY
Practice Address - City:TALIHINA
Practice Address - State:OK
Practice Address - Zip Code:74571
Practice Address - Country:US
Practice Address - Phone:918-567-7000
Practice Address - Fax:918-567-7037
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist