Healthcare Provider Details

I. General information

NPI: 1215565841
Provider Name (Legal Business Name): RACHEL H LATREMOUILLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 RINEHART WAY
AIKEN SC
29803-1703
US

IV. Provider business mailing address

PO BOX 2510
EVANS GA
30809-2510
US

V. Phone/Fax

Practice location:
  • Phone: 803-335-2200
  • Fax:
Mailing address:
  • Phone: 706-922-8274
  • Fax: 706-922-6695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number101917
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: