MEDICARE: RANDI LYNN SLOTTE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH00010884	WA

General Provider Information

NPI Number	:	1184929184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI LYNN SLOTTE RPH

Provider Business Mailing Address
First Line	:	2930 OCEAN BEACH HWY
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-3514
Country	:	US
Telephone Number	:	360-575-6246
Fax Number	:	360-575-6248

Provider Business Practice Location Address
First Line	:	2930 OCEAN BEACH HWY
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-3514
Country	:	US
Telephone Number	:	360-575-6246
Fax Number	:	360-575-6248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2011
Last Update Date	:	01/21/2011

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Directions to “ RANDI LYNN SLOTTE RPH” Practice Location

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