MEDICARE: SABRA C RINIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	325	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410001606	OTHER		MEDCO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023094802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SABRA C RINIO

Provider Business Mailing Address
First Line	:	425 N SPRING ST
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-1323
Country	:	US
Telephone Number	:	931-836-2414
Fax Number	:	931-836-3950

Provider Business Practice Location Address
First Line	:	425 N SPRING ST
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-1323
Country	:	US
Telephone Number	:	931-836-2414
Fax Number	:	931-836-3950

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	SABRA C RINIO
Credential	:	RPH
Telephone Number	:	931-836-2414

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	06/17/2008

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Directions to “SABRA C RINIO ” Practice Location

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