Organization
RANDLEMAN MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANVIR A CHODRI MD (MEDICAL DIRECTOR)
(336) 498-8500
Entity
Organization
Contact information
Practice address
702 S MAIN ST, RANDLEMAN, NC 27317-2102
(336) 498-8500
(336) 498-8522
Mailing address
702 S MAIN ST, RANDLEMAN, NC 27317-2102
(336) 498-8500
(336) 498-8522
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
19463
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2275130E
MEDICARE PTAN
NC
05
—
7902499
—
NC
Enumeration date
06/13/2006
Last updated
03/29/2012
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