Healthcare Provider Details

I. General information

NPI: 1700779121
Provider Name (Legal Business Name): RENEW MEDICAL GROUP OF MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 E RIVER BLUFF BLVD
OZARK MO
65721-8807
US

IV. Provider business mailing address

700 E REDLANDS BLVD STE U302
REDLANDS CA
92373-6109
US

V. Phone/Fax

Practice location:
  • Phone: 417-885-3000
  • Fax:
Mailing address:
  • Phone: 888-709-3118
  • Fax: 302-709-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DARIN L RENTZ
Title or Position: PRESIDENT
Credential: DO
Phone: 877-565-6701