Provider Demographics
NPI:1891123816
Name:EVANS, JOSEPH RANDALL (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RANDALL
Last Name:EVANS
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 N SUNCOAST BLVD
Mailing Address - Street 2:SEVEN RIVERS REGIONAL MEDICAL CENTER, PHARMACY DEPT
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-6712
Mailing Address - Country:US
Mailing Address - Phone:352-795-6480
Mailing Address - Fax:
Practice Address - Street 1:6201 N SUNCOAST BLVD
Practice Address - Street 2:SEVEN RIVERS REGIONAL MEDICAL CENTER, PHARMACY DEPT
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-6712
Practice Address - Country:US
Practice Address - Phone:352-795-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist