| Randleman Medical Center Llc | |
|
702 S Main St Randleman NC 27317-2102 | |
| (336) 498-8500 | |
| (336) 498-8522 |
| Full Name | Randleman Medical Center Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 702 S Main St, Randleman, North Carolina |
| Authorized Official Name and Position | Tanvir A Chodri (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3364988500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randleman Medical Center Llc 702 S Main St Randleman NC 27317-2102 Ph: (336) 498-8500 | Randleman Medical Center Llc 702 S Main St Randleman NC 27317-2102 Ph: (336) 498-8500 |
| NPI Number | 1710920335 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 03/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710920335 | NPI | - | NPPES |
| 7902499 | Medicaid | NC | |
| 2275130E | Other | NC | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 19463 (North Carolina) | Primary |
Pine Haven Family Medicine Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 604 West Academy St, Randleman, NC 27317 Phone: 336-498-1200 Fax: 336-498-1206 |