Active NPI
Nelan LLC
- Community/Retail Pharmacy
- Charlotte, NC
National Provider Identifier
1083739254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 09490
- Legal business name
- NELAN LLC
- Doing business as
- RANDOLPH MEDICAL PHARMACY
- Practice address
- 3541 Randolph Rd
Charlotte, NC 28211-1082 - Phone
- (704) 365-0707
- Fax
- (704) 442-9870
- NPI assigned
- Mar 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kuntal Lala, PHRMD
- Title
- Pharmacy Manager
- Phone
- (704) 365-0707
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 09490 | NC | Primary |
| Compounding Pharmacy | 3336C0004X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
3541 Randolph Rd
Charlotte, NC 28211-1082
Mailing address
3541 Randolph Rd
Charlotte, NC 28211-1082
Phone (704) 365-0707
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7N9490 | Medicaid | SC | |
| 0605998 | Medicaid | NC | |
| 2068170 | Other | PK |
Other names 1
- RANDOLPH MEDICAL PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930035559 | NC | DME Supplier - Pharmacy | 9133289218 | Practice locations: Charlotte, NC |
| O20200619001455 | NC | Part B Supplier - Independent Clinical Laboratory | 9133289218 | Practice locations: Charlotte, NC |
| O20240501000052 | NC | Part B Supplier - Pharmacy | 9133289218 | Practice locations: Charlotte, NC |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Charlotte, NC
- NPI 1689330086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787184000000",
"number": "1083739254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3541 RANDOLPH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111082",
"telephone_number": "704-365-0707",
"fax_number": "704-442-9870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3541 RANDOLPH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111082",
"telephone_number": "704-365-0707",
"fax_number": "704-442-9870"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NELAN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-20",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A",
"authorized_official_last_name": "LALA",
"authorized_official_first_name": "KUNTAL",
"authorized_official_title_or_position": "PHARMACY MANAGER",
"authorized_official_telephone_number": "704-365-0707",
"authorized_official_credential": "PHRMD"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NC",
"license": "09490",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7N9490",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0605998",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2068170",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RANDOLPH MEDICAL PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.