Provider Demographics
NPI:1669756839
Name:RANDALL, JOSEPH W SR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:RANDALL
Suffix:SR
Gender:M
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:RANDALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:9325 PARKWAY E
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-8303
Mailing Address - Country:US
Mailing Address - Phone:205-833-6882
Mailing Address - Fax:205-833-7063
Practice Address - Street 1:9325 PARKWAY E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-8303
Practice Address - Country:US
Practice Address - Phone:205-833-6882
Practice Address - Fax:205-833-7063
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist