Provider Demographics
NPI:1710585047
Name:BORSANIA, THITA R (RPH)
Entity Type:Individual
Prefix:
First Name:THITA
Middle Name:R
Last Name:BORSANIA
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 1:817 S CASHUA DR STE C
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6398
Mailing Address - Country:US
Mailing Address - Phone:843-713-1575
Mailing Address - Fax:877-839-0075
Practice Address - Street 1:817 S CASHUA DR STE C
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6398
Practice Address - Country:US
Practice Address - Phone:843-713-1575
Practice Address - Fax:877-839-0075
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist