Randolph, Alice H
Randolph, Alice H is an individual health care provider with primary practice located at 3872 E Harbor Light Landing Dr , Port Clinton OH 43452-3877. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Randolph, Alice H can be contacted via phone (216) 215-8000.Contact Information
Primary practice address
3872 E Harbor Light Landing Dr
Port Clinton OH 43452-3877
Phone: (216) 215-8000
Fax: (877) 734-2032
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2974 | Ohio |
Profile Details
| NPI number | 1497865885 |
|---|---|
| LBN Legal business name | Randolph, Alice H |
| Credentials | EDD MSCP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 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 | 1497865885 | NPPES |
| Ohio | Other | 000000137850 | ANTHEM |
| Ohio | MEDICAID | 0473590 | ANTHEM |
| Ohio | Other | 294762000 | ANTHEM |
| Ohio | Other | P00127008 | ANTHEM |
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