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Individual

MR. JOHN A DERENBURGER

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4210
(304) 388-8838
Mailing address
1990 PARKWOOD RD, CHARLESTON, WV 25314-2242
(304) 345-6124
(304) 388-8838

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0005220
WV

Other

Enumeration date
02/18/2006
Last updated
07/08/2007
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