Provider Demographics
NPI:1164190344
Name:CRONE, RANDALL S SR
Entity type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:S
Last Name:CRONE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 PROSPECT ST APT B5
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-7171
Mailing Address - Country:US
Mailing Address - Phone:440-822-8209
Mailing Address - Fax:
Practice Address - Street 1:1580 PROSPECT ST APT B5
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-7171
Practice Address - Country:US
Practice Address - Phone:440-309-4478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHPW8385172A00000X, 253Z00000X, 3747P1801X, 376J00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No172A00000XOther Service ProvidersDriver
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker