Healthcare Provider Details

I. General information

NPI: 1548141880
Provider Name (Legal Business Name): RANDIE ZHOU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 W CHEYENNE AVE
LAS VEGAS NV
89108-4205
US

IV. Provider business mailing address

2921 BRINDLE CT
LAS VEGAS NV
89117-2580
US

V. Phone/Fax

Practice location:
  • Phone: 702-396-0917
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24678
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: