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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