MEDICARE: RANDALL L STRONG

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
1	183500000X	Pharmacist	IN01775	NV

General Provider Information

NPI Number	:	1134277346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDALL L STRONG

Provider Business Mailing Address
First Line	:	6327 ANTELOPE CREEK CT
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-1840
Country	:	US
Telephone Number	:	702-649-2495
Fax Number	:

Provider Business Practice Location Address
First Line	:	6327 ANTELOPE CREEK CT
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-1840
Country	:	US
Telephone Number	:	702-649-2495
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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Directions to “ RANDALL L STRONG ” Practice Location

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