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NPI Code Detail

MEDICARE: DR. RENA LYNN ESTEP PHARM D

MEDICARE: DR. RENA LYNN ESTEP PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202207480VA
2183500000XPharmacist0000027041TN

General Provider Information

NPI Number : 1104147321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENA LYNN ESTEP PHARM D
Provider Business Mailing Address
First Line : 3900 FORT HENRY DR
Second Line :
City : COLONIAL HEIGHTS
State : TN
Zip : 37663-2026
Country : US
Telephone Number : 423-239-6845
Fax Number :
Provider Business Practice Location Address
First Line : 3900 FORT HENRY DR
Second Line :
City : COLONIAL HEIGHTS
State : TN
Zip : 37663-2026
Country : US
Telephone Number : 423-239-6845
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2010
Last Update Date : 06/22/2010

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