Provider Demographics
NPI:1558537076
Name:RANDALL, CAROLINE MARY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:MARY
Last Name:RANDALL
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 1:3162 JOHNSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-7604
Mailing Address - Country:US
Mailing Address - Phone:770-641-8024
Mailing Address - Fax:770-650-8151
Practice Address - Street 1:3162 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-7604
Practice Address - Country:US
Practice Address - Phone:770-641-8024
Practice Address - Fax:770-650-8151
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist