Organization
RANDY RAY STEVENS
Active
Organization
RANDY RAY STEVENS
Active
Other names
Randy Stevens Family Footcare
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY RAY STEVENS (OWNER)
(717) 561-1453
Entity
Organization
Contact information
Practice address
845 SIR THOMAS CT STE D, HARRISBURG, PA 17109-4840
(717) 561-1453
Mailing address
845 SIR THOMAS CT STE D, HARRISBURG, PA 17109-4840
(717) 561-1453
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007524777
AETNA
PA
01
—
1814385
BCBS OF PA
PA
01
—
20050085
AMERIHEALTH
PA
01
—
419111
HEALTHASSURANCE
PA
Enumeration date
07/21/2006
Last updated
08/25/2023
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