Provider Demographics
NPI:1932875275
Name:PEART, RANDALL BOYD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:BOYD
Last Name:PEART
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 1:100 APPLIED BANK BLVD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-3500
Mailing Address - Country:US
Mailing Address - Phone:484-785-9945
Mailing Address - Fax:
Practice Address - Street 1:100 APPLIED BANK BLVD
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-3500
Practice Address - Country:US
Practice Address - Phone:484-785-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist