Healthcare Provider Details

I. General information

NPI: 1730044264
Provider Name (Legal Business Name): RACHEL NICHOLA BLOCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7412 BROAD RIVER RD
IRMO SC
29063-9662
US

IV. Provider business mailing address

7412 BROAD RIVER RD
IRMO SC
29063-9662
US

V. Phone/Fax

Practice location:
  • Phone: 803-749-3046
  • Fax:
Mailing address:
  • Phone: 803-749-3046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67693
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: