Basic Information
| Provider Information | |||||||||
| NPI: | 1730653627 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHODES | ||||||||
| FirstName: | SHEMELL | ||||||||
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| Credential: | RRT/RCP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 E SCARLETT LN | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295057137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436179725 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 E CHEVES ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295062616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437772000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2019 | ||||||||
| LastUpdateDate: | 01/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 227900000X | RCP5916LL | SC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | 227900000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered |
ID Information
| ID | Type | State | Issuer | Description | RCP5916 | 01 | SC | RESPIRATORY THERAPIST | OTHER |