Provider Demographics
NPI:1437788239
Name:ROCHESTER, SAMUEL BRUCE III (PARAMEDIC)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:BRUCE
Last Name:ROCHESTER
Suffix:III
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HUDSON WATER RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7062
Mailing Address - Country:US
Mailing Address - Phone:864-809-4801
Mailing Address - Fax:
Practice Address - Street 1:333 HUDSON WATER RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-7062
Practice Address - Country:US
Practice Address - Phone:864-809-4801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC09551146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic