Provider Demographics
NPI:1598350860
Name:RANDOPLH, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:RANDOPLH
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 1:159 HIDDEN MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:JANE LEW
Mailing Address - State:WV
Mailing Address - Zip Code:26378-9519
Mailing Address - Country:US
Mailing Address - Phone:304-517-6250
Mailing Address - Fax:
Practice Address - Street 1:159 HIDDEN MEADOWS LN
Practice Address - Street 2:
Practice Address - City:JANE LEW
Practice Address - State:WV
Practice Address - Zip Code:26378-9519
Practice Address - Country:US
Practice Address - Phone:304-517-6250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker