Randy Dumornay, RPH
Individual provider Active NPI Pharmacist · King George, VA
NPI 1336744200 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1336744200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202217540 (VA)
- Practice address
- 11458 Kings Hwy
King George, VA 22485-4200 - Phone
- (540) 775-2284
- NPI assigned
- Nov 30, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202217540 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202217540 | VA | Yes |
Addresses
Primary practice location
11458 Kings Hwy
King George, VA 22485-4200
Mailing address
11458 Kings Hwy
King George, VA 22485-4200
Phone (540) 775-2284
Other names
- Dr. Randy Dumornay
Other providers in King George, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2020. 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.