Walter Randall, LN100692 is a
Licensed Practical Nurse based in Warren, Massachusetts. Walter Randall is licensed to practice in Massachusetts (license number LN100692) and his current practice location is
1210 Main St, Warren, Massachusetts. He can be reached at his office (for appointments etc.) via phone at
(717) 916-0995.
NPI number for Walter Randall is 1386363042 and his current mailing address is Po Box 6284, Brattleboro, Vermont. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1386363042.
Provider's Profile
| Full Name | Walter Randall |
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| Gender | Male |
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| Speciality | Licensed Practical Nurse |
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| Location | 1210 Main St, Warren, Massachusetts |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1386363042
- Provider Enumeration Date: 08/25/2022
- Last Update Date: 08/25/2022
Medical Identifiers
Medical identifiers for Walter Randall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386363042 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | LN100692 (Massachusetts) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Walter Randall is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Walter Randall, LN100692
Po Box 6284,
Brattleboro, VT 05302-6284
Ph: (717) 916-0995 | Walter Randall, LN100692
1210 Main St,
Warren, MA 01083-9760
Ph: (717) 916-0995 |
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