Organization Name: | RANDLEMAN MEDICAL CENTER LLC |
NPI Number: | 1710920335 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TANVIR A CHODRI (MEDICAL DIRECTOR) |
Mailing Address: | 702 S Main St Randleman |
State: | NC US |
Postal Code: | 273172102 |
Phone Number: | 3364988500 |
Fax Number: | 3364988522 |
NPI Enumeration Date: | 06/13/2006 |
NPI Last Update Date: | 03/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 19463 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |