Provider Demographics
NPI:1598059370
Name:SWEAT, RANDAL KEITH (RPH)
Entity Type:Individual
Prefix:MR
First Name:RANDAL
Middle Name:KEITH
Last Name:SWEAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 COLORADO BLVD UNIT 817
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2810
Mailing Address - Country:US
Mailing Address - Phone:303-882-7749
Mailing Address - Fax:
Practice Address - Street 1:12711 COLORADO BLVD UNIT 817
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2810
Practice Address - Country:US
Practice Address - Phone:303-882-7749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist