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General NPI Number Information
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NPI Number | 1578721460
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Entity Type | Organization
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Legal Business Name | RENNER'S PHARMACY
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 781 CHESTNUT RIDGE RD RENNER'S PHARMACY
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City | MORGANTOWN
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State | WV
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Zip | 26505-2730
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Country | US
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Telephone | 304-598-5455
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Fax | 304-598-5453
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Provider Business Mailing Address
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Address Line | 781 CHESTNUT RIDGE RD RENNER'S PHARMACY
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City | MORGANTOWN
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State | WV
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Zip | 26505-2730
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Country | US
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Telephone | 304-598-5455
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Fax | 304-598-5453
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Authorized Official
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Title or Position | VP CORPORATE HUMAN RESOURCES
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Name | JOY GAETANO
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Credential |
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Telephone | 304-554-5122
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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 | SP552266
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License Number State | WV
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