Provider Demographics
NPI:1811248586
Name:VONSEGGERN, RANDAL (PHARMD)
Entity type:Individual
Prefix:
First Name:RANDAL
Middle Name:
Last Name:VONSEGGERN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7042
Mailing Address - Country:US
Mailing Address - Phone:336-574-8020
Mailing Address - Fax:336-574-8022
Practice Address - Street 1:806 GREEN VALLEY RD
Practice Address - Street 2:SUITE 305
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7042
Practice Address - Country:US
Practice Address - Phone:336-574-8020
Practice Address - Fax:336-574-8022
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC085211835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist