Healthcare Provider Details

I. General information

NPI: 1760397335
Provider Name (Legal Business Name): RENEE TYREE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4434 E DESERT WIND DR
PHOENIX AZ
85044-6016
US

IV. Provider business mailing address

4434 E DESERT WIND DR
PHOENIX AZ
85044-6016
US

V. Phone/Fax

Practice location:
  • Phone: 480-359-0176
  • Fax: 205-262-3648
Mailing address:
  • Phone: 480-359-0176
  • Fax: 205-262-3648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS010254
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: