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Individual

MR. TITUS RANDLE II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1234 POMPEY DR, BATON ROUGE, LA 70816
(225) 610-4142
Mailing address
9444 FLORIDA BLVD, BATON ROUGE, LA 70815-1123
(225) 610-4142

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
006674536
LA
343900000X
Non-emergency Medical Transport (VAN)
Primary
006674536
LA
347C00000X
Private Vehicle
006674536
LA

Other

Enumeration date
02/20/2019
Last updated
02/20/2019
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