Renes Drug Store INC

NPI #1114095320 in Taylorville, Illinois

Provider Information

NPI Number
1114095320
Entity Type
Organization
Organization Name
Renes Drug Store INC
Primary Specialty
Pharmacy
Enumeration Date
Dec 4, 2006
Last Updated
Dec 14, 2010

Practice Location

Address
201 WEST MAIN CROSS
ZIP Code
62568-2247
Phone
(217) 824-3533

Authorized Official

Name
MR. GORDON JOHN MAZZOTTI, LICENSED REGISTERED
Title
PRESIDENT CHIEF EXECUTIVE OFFICER
Phone
(217) 824-3533

Specialties & Taxonomy Codes

Specialty
Pharmacy

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