Provider Demographics
NPI:1972937431
Name:RAINEY, ROSS DANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:DANIEL
Last Name:RAINEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 JOHN RANDOLPH DR
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-1502
Mailing Address - Country:US
Mailing Address - Phone:706-658-0064
Mailing Address - Fax:706-658-0330
Practice Address - Street 1:170 JOHN RANDOLPH DR
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-1502
Practice Address - Country:US
Practice Address - Phone:706-658-0064
Practice Address - Fax:706-658-0330
Is Sole Proprietor?:No
Enumeration Date:2013-09-02
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21158183500000X
GARPH025538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist