Provider Demographics
NPI:1932256393
Name:PADGETT, ROLAND S (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROLAND
Middle Name:S
Last Name:PADGETT
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 1:1101 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2137
Mailing Address - Country:US
Mailing Address - Phone:803-256-1930
Mailing Address - Fax:803-933-0489
Practice Address - Street 1:2700 MIDDLEBURG DR
Practice Address - Street 2:STE 109
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2416
Practice Address - Country:US
Practice Address - Phone:803-933-9183
Practice Address - Fax:803-933-0489
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist