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
- City
- Taylorville
- State
- Illinois
- 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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