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NPI Code Detail

MEDICARE: MARC BRENEMAN

MEDICARE: MARC BRENEMAN
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
1183500000XPharmacist051.297675IL
2183500000XPharmacist2014023603MO

General Provider Information

NPI Number : 1942786579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC BRENEMAN
Provider Business Mailing Address
First Line : 1517 HUDSON LNDG
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-8408
Country : US
Telephone Number : 314-682-9192
Fax Number :
Provider Business Practice Location Address
First Line : 17877 CHESTERFIELD AIRPORT RD
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63005-1211
Country : US
Telephone Number : 866-849-4481
Fax Number : 877-473-3172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 01/29/2026

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Directions to “ MARC BRENEMAN ” Practice Location

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