Healthcare Provider Details

I. General information

NPI: 1952218695
Provider Name (Legal Business Name): RANDALL C COLE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4049 BRAMBLETON AVE
ROANOKE VA
24018-3426
US

IV. Provider business mailing address

419 CAMPBELL AVE SW APT 202
ROANOKE VA
24016-3626
US

V. Phone/Fax

Practice location:
  • Phone: 540-725-1546
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202213831
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: