Provider Demographics
NPI:1518985480
Name:ASUNTO, RANDALL LEO (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:LEO
Last Name:ASUNTO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:W147N5095 DOLPHIN DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6900
Mailing Address - Country:US
Mailing Address - Phone:262-781-0743
Mailing Address - Fax:
Practice Address - Street 1:ZABLOCKI DEPT OF VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:5000 WEST NATIONAL AV
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:414-389-4276
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9000-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist