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NPI Code Detail

MEDICARE: DR. RANDALL SCOTT JUNKINS PHARMD

MEDICARE: DR. RANDALL SCOTT JUNKINS PHARMD
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
1183500000XPharmacistRP0007679WV

General Provider Information

NPI Number : 1356892525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL SCOTT JUNKINS PHARMD
Provider Business Mailing Address
First Line : 24 N MAIN ST
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1518
Country : US
Telephone Number : 304-257-1044
Fax Number : 304-257-2681
Provider Business Practice Location Address
First Line : 24 N MAIN ST
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1518
Country : US
Telephone Number : 304-257-1044
Fax Number : 304-257-2681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2016
Last Update Date : 10/21/2016

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