Provider Demographics
NPI:1427053446
Name:HARDISON, RHONDA GREENE (RPH)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:GREENE
Last Name:HARDISON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 853
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:SC
Mailing Address - Zip Code:29924-0853
Mailing Address - Country:US
Mailing Address - Phone:803-943-9327
Mailing Address - Fax:803-943-9329
Practice Address - Street 1:810 EAST ELM STREET
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924
Practice Address - Country:US
Practice Address - Phone:803-943-9329
Practice Address - Fax:803-943-9329
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC005104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC005104OtherPHARMACIST STATE LICENSE