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Organization

RENEGADE PHARMACY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNY LEE CUNNINGHAM (OWNER)
(304) 994-0635
Entity
Organization

Contact information

Practice address
RT 10 COOK PARKWAY/18 LOGAN STREET, OCEANA, WV 24870
(304) 682-0444
(304) 682-0447
Mailing address
PO BOX 69, OCEANA, WV 24870-0069
(304) 682-0444
(304) 682-0447

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
08/15/2019
Last updated
08/15/2019
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