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General NPI Number Information
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NPI Number | 1275621575
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Entity Type | Organization
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Legal Business Name | ANTWERP PHARMACY INC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 109 S MAIN ST
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City | ANTWERP
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State | OH
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Zip | 45813-0246
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Country | US
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Telephone | 419-258-2068
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Fax | 419-258-2444
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Provider Business Mailing Address
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Address Line | 109 S. MAIN ST PO BOX 246
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City | ANTWERP
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State | OH
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Zip | 45813-0246
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Country | US
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Telephone | 419-258-2068
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Fax | 419-258-2444
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Authorized Official
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Title or Position | R.PH./OWNER
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Name | BELINDA RENNO
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Credential | BS
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Telephone | 419-258-2068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 021130900
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License Number State | OH
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