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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RANDOLPH MATTILA

Active

RANDOLPH MATTILA is a Pharmacist healthcare provider located in GRANTS, New Mexico. NPI 1740680099 is currently active in the NPPES registry. Verify at CMS.

Pharmacist · GRANTS, NM

Registration Details

NPI Number
1740680099
Provider Type
Individual
Gender
Male
NPI Issued
Aug 23, 2014 (11.944057117526 yrs)
Last Updated
Aug 23, 2014
License
RP00004614 (NM)

Practice Information

Address
1208 BONITA ST
GRANTS, NM, 870202234
Browse NM providers · Browse ZIP 87020
Phone
5052872600
Primary Specialty
Pharmacist
183500000X

Other Pharmacist Providers in GRANTS, NM

Name Credential NPI
MR. BRUCE ROBERT SMITH RPH 1154345395
PHIL PARKHURST R.PH. 1154487635
MATTHEW MUNSON PHARM D 1023425998
ROGER NICOLAUS 1124435417
JOLENE COLBURN 1639586852
ALICIA M GARDNER PHARMD 1114320132
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.