RANDOLPH MATTILA
NPI 1740680099
Pharmacist in Grants, NM

Active since August 23, 2014
1208 BONITA ST, GRANTS, NM 87020(505) 287-2600 Get Directions Write a Review

NPPES record last updated: August 23, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Randolph Mattila NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDOLPH MATTILA (NPI 1740680099) is an individual pharmacist in Grants, New Mexico, licensed in New Mexico (RP00004614) and active in the NPI registry since August 2014.

NPPES Registry Identity

NPI1740680099
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameRANDOLPH MATTILA
Location Address1208 BONITA STGrants, NM 87020-2234
Mailing Address36 Hamilton RdGrants, NM 87020-3766
Sole ProprietorNo
Enumeration DateAugust 23, 2014
NPI 1740680099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in NM · RP00004614
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

1208 BONITA ST, Grants, NM 87020

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
1208 BONITA ST
GRANTS, NM 87020
Pharmacist
1208 BONITA ST
GRANTS, NM 87020
Family Medicine
1208 BONITA ST
GRANTS, NM 87020
Pharmacist
1208 BONITA ST
GRANTS, NM 87020
Community Health Worker
1208 BONITA ST
GRANTS, NM 87020
Pharmacy (Community/Retail Pharmacy)
1208 BONITA ST
GRANTS, NM 87020
Family Medicine
1208 BONITA ST
GRANTS, NM 87020
Pharmacy (Community/Retail Pharmacy)
1208 BONITA ST
GRANTS, NM 87020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randolph Mattila's NPI number?

The NPI number for Randolph Mattila is 1740680099. It was assigned to this individual provider in the NPPES registry on August 23, 2014.

Where is Randolph Mattila located?

Randolph Mattila practices at 1208 Bonita St, Grants, NM 87020. The listed phone number is (505) 287-2600.

What is Randolph Mattila's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Randolph Mattila was last updated on August 23, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.