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General NPI Number Information
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NPI Number | 1972887867
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Entity Type | Individual
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Provider Name | VICTORIA LEIGH RANDALL-PENWELL PHARM D
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Gender | Female
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 6000 S PENN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-3302
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Country | US
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Telephone | 405-681-1419
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Fax | 405-681-6873
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Provider Business Mailing Address
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Address Line | 6000 S PENN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-3302
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Country | US
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Telephone | 405-681-1419
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Fax | 405-681-6873
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14503
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License Number State | OK
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