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General NPI Number Information
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NPI Number | 1215755947
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Entity Type | Organization
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Legal Business Name | RENEW MEDICAL GROUP OF ARKANSAS LTD
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 7301 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72903-4100
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Country | US
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Telephone | 479-314-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E REDLANDS BLVD STE U302
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City | REDLANDS
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State | CA
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Zip | 92373-6109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARIN L RENTZ
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Credential | DO
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Telephone | 720-984-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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