Mattila, Randolph

Mattila, Randolph is an individual health care provider with primary practice located at 1208 Bonita St , Grants NM 87020-2234. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Mattila, Randolph can be contacted via phone (505) 287-2600.

Contact Information

Primary practice address
1208 Bonita St Grants NM 87020-2234
Phone: (505) 287-2600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X RP00004614 New Mexico

Profile Details

NPI number 1740680099
LBN Legal business name Mattila, Randolph
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2014
Last updated Aug 23rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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