Provider Demographics
NPI:1932839412
Name:RENTZ, SAMUEL DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:DAVID
Last Name:RENTZ
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 1:402 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-2923
Mailing Address - Country:US
Mailing Address - Phone:864-654-1771
Mailing Address - Fax:
Practice Address - Street 1:402 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2923
Practice Address - Country:US
Practice Address - Phone:864-654-1771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033670183500000X
SC43876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist