Provider Demographics
NPI:1053523571
Name:RANDLES, MARGIE ANN
Entity type:Individual
Prefix:MRS
First Name:MARGIE
Middle Name:ANN
Last Name:RANDLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 S. 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2021
Mailing Address - Country:US
Mailing Address - Phone:740-623-0679
Mailing Address - Fax:
Practice Address - Street 1:350 S. 4TH STREET
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2021
Practice Address - Country:US
Practice Address - Phone:740-623-0679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2409843302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHIP#2409843OtherHOME HEALTH AIDE