Individual provider Active NPI

Randall Charles

  • Pharmacist
  • Medina, OH
National Provider Identifier
1679969919
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03223157 Issued in OH
Practice address
6385 Highland Green Dr
Medina, OH 44256-6504
Phone
(330) 721-2343
NPI assigned
Apr 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03223157 OH Primary

Addresses

Primary practice location

6385 Highland Green Dr
Medina, OH 44256-6504

Mailing address

6385 Highland Green Dr
Medina, OH 44256-6504
Phone (330) 721-2343

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

State licenses

LicenseStateTypeSpecialty
03223157OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1679969919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 HIGHLAND GREEN DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442566504",
            "telephone_number": "330-721-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 HIGHLAND GREEN DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442566504",
            "telephone_number": "330-721-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "RANDALL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03223157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.