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General NPI Number Information
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NPI Number | 1396754891
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Entity Type | Organization
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Legal Business Name | RENGE PHARMACY
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 833 F ST
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City | FRESNO
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State | CA
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Zip | 93706-3418
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Country | US
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Telephone | 559-264-2808
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Fax | 559-264-1852
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Provider Business Mailing Address
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Address Line | 833 F ST
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City | FRESNO
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State | CA
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Zip | 93706-3418
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Country | US
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Telephone | 559-264-2808
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Fax | 559-264-1852
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. MELVIN K. RENGE
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Credential | PHARM. D.
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Telephone | 559-264-2808
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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 | RPH 33277
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PHY21926
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY21926
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY 21926
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License Number State | CA
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