Randall, Jeffrey Dwayne
Randall, Jeffrey Dwayne is an individual health care provider with primary practice located at 501 Highway 90 E , Little River SC 29566-9261. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Randall, Jeffrey Dwayne can be contacted via phone (803) 422-7231.Contact Information
Primary practice address
501 Highway 90 E
Little River SC 29566-9261
Phone: (803) 422-7231
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1376688796 |
|---|---|
| LBN Legal business name | Randall, Jeffrey Dwayne |
| Credentials | MPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Sep 18th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376688796 | NPPES |
| South Carolina | MEDICAID | 421504 |
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