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General NPI Number Information
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NPI Number | 1659235208
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Entity Type | Individual
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Provider Name | JANA ELISE RICH
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Gender | Female
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 222 E MEDICAL LN STE 101
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4850
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Country | US
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Telephone | 803-739-3660
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Fax | 803-739-3660
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Provider Business Mailing Address
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Address Line | 653 CLOVER VIEW RD
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City | CHAPIN
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State | SC
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Zip | 29036-7117
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Country | US
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Telephone | 602-677-1530
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Fax | 803-739-3660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 31307
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License Number State | SC
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