Healthcare Provider Details

I. General information

NPI: 1962792325
Provider Name (Legal Business Name): DOLORES ANN ZRENCHAK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6556 N RIDGE RD
MADISON OH
44057-2552
US

IV. Provider business mailing address

6556 N RIDGE RD
MADISON OH
44057
US

V. Phone/Fax

Practice location:
  • Phone: 440-428-1128
  • Fax: 440-428-0011
Mailing address:
  • Phone: 440-428-1128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03310732
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP027830L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: