Provider Demographics
NPI:1972858314
Name:GRAMLING, REBECCA S (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:GRAMLING
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 1:1106 JOHN C CALHOUN DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-6656
Mailing Address - Country:US
Mailing Address - Phone:803-531-2079
Mailing Address - Fax:803-531-2134
Practice Address - Street 1:1106 JOHN C CALHOUN DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-6656
Practice Address - Country:US
Practice Address - Phone:803-531-2079
Practice Address - Fax:803-531-2134
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist