MEDICARE: EBONY S ROBINSON

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	246R00000X	Pathology Technician		SC

General Provider Information

NPI Number	:	1619844818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBONY S ROBINSON

Provider Business Mailing Address
First Line	:	1901 MAIN ST FL 18
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2435
Country	:	US
Telephone Number	:	803-250-1468
Fax Number	:	803-537-3431

Provider Business Practice Location Address
First Line	:	1901 MAIN ST FL 18
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2435
Country	:	US
Telephone Number	:	803-250-1468
Fax Number	:	803-573-3431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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