Organization
RENATUS HEALTH LLC
Active
Other names
Tarrytown Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK NEWBERRY (MANAGING MEMBER)
(512) 617-3530
Entity
Organization
Contact information
Practice address
1600 W 38TH ST STE 408, AUSTIN, TX 78731-6407
(512) 617-3530
(844) 965-9846
Mailing address
1600 W 38TH ST STE 408, AUSTIN, TX 78731-6407
(512) 617-3530
(512) 617-3531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
31564
TX
3336C0003X
Community/Retail Pharmacy
31564
TX
3336S0011X
Specialty Pharmacy
Primary
31564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153410
PK
—
Enumeration date
07/31/2015
Last updated
01/09/2019
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