Active NPI
Randall Haskell Hooper, RPH
- Pharmacist
- Lauderdale by the Sea, FL
National Provider Identifier
1164019014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS31066
- Practice address
- 4725 N Ocean Dr
Lauderdale by the Sea, FL 33308-2914 - Phone
- (954) 942-8648
- NPI assigned
- Dec 27, 2020
- Last updated
- Dec 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS31066 | FL | Primary |
Addresses
Primary practice location
4725 N Ocean Dr
Lauderdale by the Sea, FL 33308-2914
Mailing address
2625 NE 10TH Ter
Wilton Manors, FL 33334-3713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS31066 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Current | Accepting new patients | |
| Holiday CVS L.L.C. | Past | Accepting new patients |
Locations
4725 N Ocean Dr
Lauderdale by the Sea, FL 33308
Phone (954) 942-8648
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609027200000",
"number": "1164019014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 NE 10TH TER",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333343713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 N OCEAN DR",
"city": "LAUDERDALE BY THE SEA",
"state": "FL",
"postal_code": "333082914",
"telephone_number": "954-942-8648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOPER",
"first_name": "RANDALL",
"middle_name": "HASKELL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-27",
"last_updated": "2020-12-27",
"certification_date": "2020-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS31066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lauderdale by the Sea, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.