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NPI Code Detail

MEDICARE: STANLEY MICHAEL RENTZ RPH

MEDICARE:   STANLEY MICHAEL RENTZ  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist12624GA

General Provider Information

NPI Number : 1467449090
Entity Type Code : Individual
Provider Name (Legal Business Name) : STANLEY MICHAEL RENTZ RPH
Provider Business Mailing Address
First Line : 111 E GORDON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31601-4554
Country : US
Telephone Number : 229-244-8083
Fax Number : 229-245-6031
Provider Business Practice Location Address
First Line : 111 E GORDON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31601-4554
Country : US
Telephone Number : 229-242-1925
Fax Number : 229-245-6031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 07/08/2007

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Directions to “ STANLEY MICHAEL RENTZ RPH” Practice Location

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