1396043246 NPI number — MR. ROBERT INMAN HODGES PHARMD

Table of content: MR. ROBERT INMAN HODGES PHARMD (NPI 1396043246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396043246 NPI number — MR. ROBERT INMAN HODGES PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HODGES
Provider First Name:
ROBERT
Provider Middle Name:
INMAN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396043246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 MERCANTILE PLACE
Provider Second Line Business Mailing Address:
PHARMACY
Provider Business Mailing Address City Name:
FORT MILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-547-0585
Provider Business Mailing Address Fax Number:
803-547-0524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 MERCANTILE PLACE
Provider Second Line Business Practice Location Address:
PHARMACY
Provider Business Practice Location Address City Name:
FORT MILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-547-0585
Provider Business Practice Location Address Fax Number:
803-547-0524
Provider Enumeration Date:
03/02/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  13071 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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