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NPI Code Detail

MEDICARE: DR. RANDALL LLOYD BOX P.D.

MEDICARE: DR. RANDALL LLOYD BOX P.D.
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
1183500000XPharmacist6934AR
2183500000XPharmacistRPH033797GA

General Provider Information

NPI Number : 1013904408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL LLOYD BOX P.D.
Provider Business Mailing Address
First Line : 2580 SANDY PLAINS RD
Second Line :
City : MARIETTA
State : GA
Zip : 30066-5798
Country : US
Telephone Number : 770-565-5681
Fax Number :
Provider Business Practice Location Address
First Line : 2580 SANDY PLAINS RD
Second Line :
City : MARIETTA
State : GA
Zip : 30066-5798
Country : US
Telephone Number : 770-565-5681
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 12/22/2022

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