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General NPI Number Information
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NPI Number | 1366544140
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Entity Type | Organization
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Legal Business Name | REDNER'S MARKETS, INC.
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 2977 STATE ROUTE 22
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City | FREDERICKSBURG
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State | PA
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Zip | 17026-9304
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Country | US
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Telephone | 717-865-6566
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Fax | 717-865-1664
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Provider Business Mailing Address
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Address Line | 2977 STATE ROUTE 22
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City | FREDERICKSBURG
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State | PA
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Zip | 17026-9304
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Country | US
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Telephone | 717-865-6566
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Fax | 717-865-1664
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Authorized Official
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Title or Position | CONTRACT & COMPLIANCE COORDINATOR
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Name | MRS. NICOLE KELLER
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Credential | MPH
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Telephone | 610-926-3129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PP412177L
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License Number State | PA
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