Healthcare Provider Details

I. General information

NPI: 1972810034
Provider Name (Legal Business Name): KENNETH RAY TRENARY II R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5054 GERRARDSTOWN ROAD
INWOOD WV
25428
US

IV. Provider business mailing address

PO BOX 1903
INWOOD WV
25428-1903
US

V. Phone/Fax

Practice location:
  • Phone: 304-229-2400
  • Fax: 304-229-2906
Mailing address:
  • Phone: 304-229-2400
  • Fax: 304-229-2906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0005079
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: