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NPI Code Detail

MEDICARE: MR. RANDALL L LINDVALL RPH

MEDICARE: MR. RANDALL L LINDVALL 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
1183500000XPharmacist9786OK
21835P1300XPsychiatric Pharmacist040912MO

General Provider Information

NPI Number : 1114019601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RANDALL L LINDVALL RPH
Provider Business Mailing Address
First Line : 501 SW WINDMILL LN
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64082-4620
Country : US
Telephone Number : 816-616-9182
Fax Number :
Provider Business Practice Location Address
First Line : 2323 E 63RD ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64130-3462
Country : US
Telephone Number : 816-234-8121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 07/22/2013

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