Healthcare Provider Details

I. General information

NPI: 1255465944
Provider Name (Legal Business Name): RANDOLPH HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 WHITE OAK ST
ASHEBORO NC
27203-5434
US

IV. Provider business mailing address

364 WHITE OAK ST
ASHEBORO NC
27203-5434
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-5151
  • Fax:
Mailing address:
  • Phone: 336-625-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. LYNWOOD R. WHITE
Title or Position: VP FINANCE
Credential:
Phone: 336-625-5151