MEDICARE: RANDI BORN

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	17795	AL

General Provider Information

NPI Number	:	1538576087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI BORN

Provider Business Mailing Address
First Line	:	310 PELHAM AVE SW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5016
Country	:	US
Telephone Number	:	256-534-2333
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 PELHAM AVE SW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5016
Country	:	US
Telephone Number	:	256-534-2333
Fax Number	:

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

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	06/26/2021

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Directions to “ RANDI BORN ” Practice Location

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