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NPI Code Detail

MEDICARE: RANDALL K OVERTON RPH

MEDICARE:   RANDALL K OVERTON  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
1183500000XPharmacistRPH013658GA

General Provider Information

NPI Number : 1609187988
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL K OVERTON RPH
Provider Business Mailing Address
First Line : 1228 BATTLEFIELD PKWY
Second Line :
City : FT OGLETHORPE
State : GA
Zip : 30742-4008
Country : US
Telephone Number : 706-861-7284
Fax Number : 706-861-7836
Provider Business Practice Location Address
First Line : 1228 BATTLEFIELD PKWY
Second Line :
City : FT OGLETHORPE
State : GA
Zip : 30742-4008
Country : US
Telephone Number : 706-861-7284
Fax Number : 706-861-7836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2010
Last Update Date : 07/01/2010

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Directions to “ RANDALL K OVERTON RPH” Practice Location

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