Edwards, Charles Randall

Edwards, Charles Randall is an sole proprietor health care provider with primary practice located at 1303 Greensboro Street Ext , Lexington NC 27295-1924. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Edwards, Charles Randall can be contacted via phone (336) 249-0237.

Contact Information

Primary practice address
1303 Greensboro Street Ext Lexington NC 27295-1924
Fax: (336) 243-7685
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0879 North Carolina

Profile Details

NPI number 1124153838
LBN Legal business name Edwards, Charles Randall
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2007
Last updated Jul 26th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124153838 NPPES
North Carolina MEDICAID 6000633

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