Randy John Shaneck, PHARM D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

03129415 Issued in OH

Practice address

3300 Navarre Ave
Oregon, OH 43616

Phone

(419) 691-7034

NPI assigned

Dec 15, 2017

Last updated

Jan 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• The Kroger Co

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Oregon, OH
  • NPI 1831123637
  NPD (past)

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579305600000",
    "number": "1659887495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KROGER PHARMACY 3300 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "43616",
            "telephone_number": "419-691-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "43616",
            "telephone_number": "419-691-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANECK",
        "first_name": "RANDY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2020-01-18",
        "certification_date": "2020-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03129415",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03129415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davon Sephus
• Chester Servick, CRNA
• Cherie Lynn Sexton, PCPNP
• Joseph Patrick Sexton, D.D.S.
• Agha Shahid, M.D.
• Angela Marie Shank
• Ajeet L Sharma, MD
• Tiffany Ann Sharp, LPTA
• Debbie Shaughnessy
• Phebe E Shawver, NP-C

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon, OH
• Providers in Oregon, OH by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.

Verify at the official NPI Registry.