Provider Demographics
NPI:1689971160
Name:DANCY, CHAD
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:DANCY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 W COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:BATESBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29006-2124
Mailing Address - Country:US
Mailing Address - Phone:803-532-2586
Mailing Address - Fax:
Practice Address - Street 1:127 W COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:BATESBURG
Practice Address - State:SC
Practice Address - Zip Code:29006-2124
Practice Address - Country:US
Practice Address - Phone:803-532-2586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist