Provider Demographics
NPI:1982023602
Name:CHANCEY, SAMUEL (RPH)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:CHANCEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3581 RICHLAND AVE W
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6311
Mailing Address - Country:US
Mailing Address - Phone:803-648-6464
Mailing Address - Fax:803-648-6840
Practice Address - Street 1:3581 RICHLAND AVE W
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6311
Practice Address - Country:US
Practice Address - Phone:803-648-6464
Practice Address - Fax:803-648-6840
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist