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General NPI Number Information
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NPI Number | 1376758532
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Entity Type | Organization
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Legal Business Name | JOHN RENO
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/15/2011
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Provider Practice Location Address
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Address Line | 519 MAIN ST BOX 68
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City | JETMORE
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State | KS
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Zip | 67854-0068
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Country | US
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Telephone | 620-357-8305
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Fax | 620-357-8305
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Provider Business Mailing Address
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Address Line | 519 MAIN ST BOX 68
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City | JETMORE
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State | KS
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Zip | 67854-0068
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Country | US
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Telephone | 620-357-8305
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Fax | 620-357-8305
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Authorized Official
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Title or Position | PHARMACISTOWNER
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Name | MR. JOHN RENO
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Credential | RPH
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Telephone | 620-357-8305
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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 | 6360
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License Number State | KS
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