Healthcare Provider Details

I. General information

NPI: 1780588871
Provider Name (Legal Business Name): CARRIE T RICKENBAKER ROGERS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 N IRBY ST
FLORENCE SC
29501-2808
US

IV. Provider business mailing address

1032 ACKERMAN DR
SUMMERTON SC
29148-7550
US

V. Phone/Fax

Practice location:
  • Phone: 843-667-9414
  • Fax: 843-647-6457
Mailing address:
  • Phone: 803-460-1592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67916
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: