Healthcare Provider Details

I. General information

NPI: 1932928389
Provider Name (Legal Business Name): RHONDA PAGE MOXEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 ACORN DR
DILLON SC
29536-7458
US

IV. Provider business mailing address

1814 ACORN DR
DILLON SC
29536-7458
US

V. Phone/Fax

Practice location:
  • Phone: 843-250-9347
  • Fax:
Mailing address:
  • Phone: 843-250-9347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIHCP-2249
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: