Vivian Bush Randolph, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

023968 Issued in GA

Practice address

119 Canal St Ste 102
Pooler, GA 31322-4094

Phone

(912) 226-0857

NPI assigned

May 27, 2011

Sex

Female

Sole proprietor

Yes

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 and National Provider Directory roles.

• SC House Calls Inc

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1518048859
  NPD (past)

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1679866347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CANAL ST STE 102",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224094",
            "telephone_number": "912-226-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CANAL ST STE 102",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224094",
            "telephone_number": "912-226-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "VIVIAN",
        "middle_name": "BUSH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "023968",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "11996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Areli Ramos
• Melody Ramsey
• Randall Crum Inc.
• Rachel Danielle Randle
• Peyton Randolph
• Ranicki Chiropractic Wellness Center, PC
• Stephen Aage Ranicki, D.C.
• Megan Rebar
• Michelle Reed
• Carma Reeves

• Pharmacist in Pooler, GA
• Providers in Pooler, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.