Randolph J Weaver

Primary specialty

PharmacyTaxonomy code 333600000X

License

034106 Issued in NY

Legal business name

RANDOLPH J WEAVER

Practice address

7181 State Route 54
Bath, NY 14810-9502

Phone

(607) 664-9039

NPI assigned

Jan 5, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Randolph Weaver

Title

Owner/RPH

Phone

(607) 664-9039

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Village Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1104282318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "14810",
            "telephone_number": "607-664-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7181 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148109502",
            "telephone_number": "607-664-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH J WEAVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "OWNER/RPH",
        "authorized_official_telephone_number": "607-664-9039"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "034106",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157398",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Proaction of Steuben and Yates Inc
• Proaction of Steuben and Yates, Inc.
• Cheryl Pruett II, PH.D.
• Arielle Marie Pygott, CPHT
• Rosemary Barbara Randall, RNFNP
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• Robin Richardson
• Cynthia Ripple, N.P.

• Pharmacy in Bath, NY
• Providers in Bath, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.