Healthcare Provider Details

I. General information

NPI: 1063929263
Provider Name (Legal Business Name): CPC RINEHART DISPENSARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
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: 803-649-7966
Mailing address:
  • Phone: 706-922-8251
  • Fax: 706-922-6695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: ERIN DANSBY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 706-922-8251