Healthcare Provider Details

I. General information

NPI: 1417042839
Provider Name (Legal Business Name): REDNER'S MARKETS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5471 POTTSVILLE PIKE
LEESPORT PA
19533-8633
US

IV. Provider business mailing address

5471 POTTSVILLE PIKE
LEESPORT PA
19533-8633
US

V. Phone/Fax

Practice location:
  • Phone: 610-926-3129
  • Fax: 610-916-6854
Mailing address:
  • Phone: 610-926-3129
  • Fax: 610-916-6854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP412257L
License Number StatePA

VIII. Authorized Official

Name: LINDA H ZEBROWSKI
Title or Position: PHARMACIST
Credential:
Phone: 610-926-3129