Randall Flores, PHARMD
Individual provider Active NPI Pharmacist · Douglas, AZ
NPI 1023650249 · NPPES record last updated Mar 7, 2024
Key facts
- NPI
- 1023650249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S024755 (AZ)
- Practice address
- 1111 N F Ave
Douglas, AZ 85607-1918 - Phone
- (520) 459-3110
- NPI assigned
- Oct 9, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65892 | TX | MD | Professional Counselor |
| S024755 | AZ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 65892 | TX | |
| Pharmacist | 183500000X | S024755 | AZ | Yes |
Addresses
Primary practice location
1111 N F Ave
Douglas, AZ 85607-1918
Mailing address
1205 N F Ave
Douglas, AZ 85607-1920
Phone (520) 459-3110
Other providers in Douglas, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.