Healthcare Provider Details

I. General information

NPI: 1124942024
Provider Name (Legal Business Name): RONALD BRETT RENFROW PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 N MAIN ST
BEAVER DAM KY
42320-8955
US

IV. Provider business mailing address

1209 N MAIN ST
BEAVER DAM KY
42320-8955
US

V. Phone/Fax

Practice location:
  • Phone: 270-274-3318
  • Fax: 270-274-3340
Mailing address:
  • Phone: 270-274-3318
  • Fax: 270-274-3340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number017906
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: