Healthcare Provider Details

I. General information

NPI: 1487041463
Provider Name (Legal Business Name): SIDNEY RITTS ESKEW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD
GREENVILLE SC
29605-4210
US

IV. Provider business mailing address

114 CIRCLE GROVE CT
GREER SC
29650-5122
US

V. Phone/Fax

Practice location:
  • Phone: 864-979-8169
  • Fax:
Mailing address:
  • Phone: 864-979-8169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number209343
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: