Provider Demographics
NPI:1063241537
Name:RENTZ, CASSIDY BATES (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:CASSIDY
Middle Name:BATES
Last Name:RENTZ
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 GAURA LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8446
Mailing Address - Country:US
Mailing Address - Phone:843-513-3897
Mailing Address - Fax:
Practice Address - Street 1:1401 BEN SAWYER BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4574
Practice Address - Country:US
Practice Address - Phone:843-881-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPH.60292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist