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NPI Code Detail

MEDICARE: JAYVAUGHN RANDLE-DUMAS

MEDICARE: JAYVAUGHN RANDLE-DUMAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideOH

General Provider Information

NPI Number : 1033071634
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYVAUGHN RANDLE-DUMAS
Provider Business Mailing Address
First Line : 4273 HOLSTEIN DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-3775
Country : US
Telephone Number : 614-352-7466
Fax Number :
Provider Business Practice Location Address
First Line : 4273 HOLSTEIN DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-3775
Country : US
Telephone Number : 614-352-7466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ JAYVAUGHN RANDLE-DUMAS ” Practice Location

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