Provider Demographics
NPI:1366509960
Name:RHOAD, GENE ELLIOTT (RPH)
Entity type:Individual
Prefix:MR
First Name:GENE
Middle Name:ELLIOTT
Last Name:RHOAD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 VONDA KAY CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9166
Mailing Address - Country:US
Mailing Address - Phone:803-356-2407
Mailing Address - Fax:
Practice Address - Street 1:120 W COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:BATESBURG
Practice Address - State:SC
Practice Address - Zip Code:29006-2100
Practice Address - Country:US
Practice Address - Phone:803-532-3616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4201668Medicare UPIN