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NPI 1962361618

NPI 1962361618 : RATHOMPSON IN : PENDLETON, SC

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General NPI Number Information
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    NPI Number           |    1962361618
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    Entity Type          |    Organization 
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    Legal Business Name  |    RATHOMPSON IN 
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Dates
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    Enumeration Date     |    01/19/2026
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    Last Update Date     |    01/22/2026
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Provider Practice Location Address
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    Address Line         |    7511 HIGHWAY 76 STE 400 
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    City                 |    PENDLETON
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    State                |    SC
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    Zip                  |    29670-9291
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    Country              |    US
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    Telephone            |    864-502-0102
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7511 HIGHWAY 76 STE 400 
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    City                 |    PENDLETON
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    State                |    SC
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    Zip                  |    29670-9291
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    Country              |    US
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    Telephone            |    864-502-0102
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. REGINALD ALLEN THOMPSON 
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    Credential           |    
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    Telephone            |    770-617-2913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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