Provider Demographics
NPI:1053656678
Name:RHODES, JENNIFER S (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:RHODES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BUCKWALTER PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-5155
Mailing Address - Country:US
Mailing Address - Phone:843-815-6435
Mailing Address - Fax:843-815-6447
Practice Address - Street 1:101 BUCKWALTER PLACE BLVD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5155
Practice Address - Country:US
Practice Address - Phone:843-815-6435
Practice Address - Fax:843-815-6447
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist