Healthcare Provider Details

I. General information

NPI: 1730005331
Provider Name (Legal Business Name): LISA RHYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COURTENAY DR
CHARLESTON SC
29425-8911
US

IV. Provider business mailing address

28 ANDERSON AVE
CHARLESTON SC
29412-3724
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-5589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13777
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: