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NPI Code Detail

MEDICARE: MS. RENEE VERGNOL RPH

MEDICARE: MS. RENEE VERGNOL RPH
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
1183500000XPharmacist28RI01819600NJ

General Provider Information

NPI Number : 1144502857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RENEE VERGNOL RPH
Provider Business Mailing Address
First Line : 406 S WASHINGTON AVE
Second Line :
City : BERGENFIELD
State : NJ
Zip : 07621-4312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 406 S WASHINGTON AVE
Second Line :
City : BERGENFIELD
State : NJ
Zip : 07621-4312
Country : US
Telephone Number : 201-384-4447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2011
Last Update Date : 09/20/2011

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