Provider Demographics
NPI:1437107745
Name:PRITCHARD, RITA G (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:G
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:RITA
Other - Middle Name:G
Other - Last Name:GROMLOVITS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:101 EUGENE CT
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9702
Mailing Address - Country:US
Mailing Address - Phone:864-295-9634
Mailing Address - Fax:864-295-9634
Practice Address - Street 1:2435 FOREST DR
Practice Address - Street 2:MAILBOX 87
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2026
Practice Address - Country:US
Practice Address - Phone:803-256-5336
Practice Address - Fax:803-256-5734
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1062367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ31356Medicare ID - Type Unspecified