Provider Demographics
NPI:1235317868
Name:DRINKALL CHIROPRACTIC LIFE CENTER INC.
Entity Type:Organization
Organization Name:DRINKALL CHIROPRACTIC LIFE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:DRINKALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-276-8833
Mailing Address - Street 1:11489 SC HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-9137
Mailing Address - Country:US
Mailing Address - Phone:803-276-8833
Mailing Address - Fax:803-276-8837
Practice Address - Street 1:11489 SC HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-9137
Practice Address - Country:US
Practice Address - Phone:803-276-8833
Practice Address - Fax:803-276-8837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH0718Medicaid
SC1487623807OtherINDIVIDUAL NPI
SC249298758OtherBLUE CROSS BLUE SHIELD
SCT242960281Medicare UPIN