Provider Demographics
NPI:1417076944
Name:TURNER, RAINE W (RPH)
Entity Type:Individual
Prefix:
First Name:RAINE
Middle Name:W
Last Name:TURNER
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 1:474 CECILY CT
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-5062
Mailing Address - Country:US
Mailing Address - Phone:706-321-8311
Mailing Address - Fax:
Practice Address - Street 1:6770 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-7201
Practice Address - Country:US
Practice Address - Phone:706-653-9224
Practice Address - Fax:706-653-6274
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist