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General NPI Number Information
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NPI Number | 1700779121
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Entity Type | Organization
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Legal Business Name | RENEW MEDICAL GROUP OF MISSOURI
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 3050 E RIVER BLUFF BLVD
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City | OZARK
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State | MO
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Zip | 65721-8807
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Country | US
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Telephone | 417-885-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E REDLANDS BLVD STE U302
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City | REDLANDS
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State | CA
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Zip | 92373-6109
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Country | US
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Telephone | 888-709-3118
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Fax | 302-709-2402
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARIN L RENTZ
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Credential | DO
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Telephone | 877-565-6701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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