Stephanie Lina Randall, RPH

Individual provider Active NPI Pharmacist · Buxton, ME

NPI 1851491773 · NPPES record last updated Aug 21, 2013

Key facts

NPI
1851491773
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PR0004624 (ME)
Practice address
226 Parker Farm Rd
Buxton, ME 04093-3150
Phone
(207) 727-5139
Fax
(207) 727-5509
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
PS32623FLMDPharmacist
PR0004624MEMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS32623 FL
Pharmacist 183500000X PR0004624 ME Yes

Addresses

Primary practice location

226 Parker Farm Rd
Buxton, ME 04093-3150

Mailing address

36 Fengler Rd
Scarborough, ME 04074-8490
Phone (207) 883-2321

Other identifiers

IdentifierTypeStateIssuer
109127100MedicaidFL
109127101OtherFLMEDICAID DME

Other names

  • Ms. Stephanie Lina Hebert Former name

Other providers in Buxton, ME

All providers in Buxton, ME · Pharmacist in Maine

Sources for this page

Verify at the official NPI Registry.