Organization
RANDOLPH RADIOLOGICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY MCNEILL LEDWELL (BUSINESS MANAGER)
(336) 629-6565
Entity
Organization
Contact information
Practice address
364 WHITE OAK ST, ASHEBORO, NC 27203-5434
(336) 629-6565
(336) 626-5640
Mailing address
PO BOX 1430, ASHEBORO, NC 27204-1430
(336) 629-6565
(336) 626-5640
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
39346
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2504
BLUE CROSS
NC
05
—
8902504
—
NC
Enumeration date
02/23/2006
Last updated
08/22/2020
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