MEDICARE: RANDY MARTINS HEALTH AND WELLNESS

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	3336C0004X	Compounding Pharmacy

General Provider Information

NPI Number	:	1881292431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RANDY MARTINS HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	9947 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-6923
Country	:	US
Telephone Number	:	865-909-9713
Fax Number	:

Provider Business Practice Location Address
First Line	:	9947 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-6923
Country	:	US
Telephone Number	:	865-909-9713
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID RANDALL MARTIN
Credential	:	PHARMD
Telephone Number	:	865-909-9713

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	04/07/2025

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