Provider Demographics
NPI:1467062885
Name:TOURCHETTE, RANDY SCOTT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:SCOTT
Last Name:TOURCHETTE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9935 MARINER ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-8267
Mailing Address - Country:US
Mailing Address - Phone:231-720-5804
Mailing Address - Fax:
Practice Address - Street 1:1223 PHOENIX ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-7911
Practice Address - Country:US
Practice Address - Phone:269-639-3510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-01
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist