Provider Demographics
NPI:1407990484
Name:HAHN, RODNEY C (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:C
Last Name:HAHN
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 1:220 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29696-2821
Mailing Address - Country:US
Mailing Address - Phone:864-638-3502
Mailing Address - Fax:864-985-0722
Practice Address - Street 1:211 INGLES PL
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-0848
Practice Address - Country:US
Practice Address - Phone:864-886-0615
Practice Address - Fax:864-985-0722
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC774813Medicaid