Provider Demographics
NPI:1457577454
Name:WINDHAM, RANDY PRICE II (RPH)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:PRICE
Last Name:WINDHAM
Suffix:II
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 1:80 SARA LN
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-7938
Mailing Address - Country:US
Mailing Address - Phone:606-877-3197
Mailing Address - Fax:
Practice Address - Street 1:975 S LAUREL RD STE A
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-7862
Practice Address - Country:US
Practice Address - Phone:606-864-6324
Practice Address - Fax:606-877-9634
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist