Organization
ROANOKE HEALTHCARE AUTHORITY
Active
Other names
RANDOLPH MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY HARLIN (CEO)
(334) 863-4111
Entity
Organization
Contact information
Practice address
59928 HIGHWAY 22, ROANOKE, AL 36274-2410
(334) 863-4111
(334) 863-5427
Mailing address
PO BOX 670, ROANOKE, AL 36274-0670
(334) 863-4111
(334) 863-5427
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
H5601
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51534246
PREFERRED LAB
AL
Enumeration date
05/14/2007
Last updated
08/22/2020
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