Provider Demographics
NPI:1821311622
Name:ORCUTT, RANDELL W (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RANDELL
Middle Name:W
Last Name:ORCUTT
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 OLTON RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-6630
Mailing Address - Country:US
Mailing Address - Phone:806-288-9490
Mailing Address - Fax:806-296-0199
Practice Address - Street 1:3320 OLTON RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-6630
Practice Address - Country:US
Practice Address - Phone:806-288-9490
Practice Address - Fax:806-296-0199
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-20342-1768-0171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator