Provider Demographics
NPI:1063929263
Name:CPC RINEHART DISPENSARY
Entity type:Organization
Organization Name:CPC RINEHART DISPENSARY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-922-8251
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-2510
Mailing Address - Country:US
Mailing Address - Phone:706-922-8251
Mailing Address - Fax:706-922-6695
Practice Address - Street 1:131 RINEHART WAY
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-1703
Practice Address - Country:US
Practice Address - Phone:803-335-2200
Practice Address - Fax:803-649-7966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR PRIMARY CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-09
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site