Organization
RENGE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN K. RENGE PHARM. D. (OWNER/PHARMACIST)
(559) 264-2808
Entity
Organization
Contact information
Practice address
833 F ST, FRESNO, CA 93706-3418
(559) 264-2808
(559) 264-1852
Mailing address
833 F ST, FRESNO, CA 93706-3418
(559) 264-2808
(559) 264-1852
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH 33277
CA
332B00000X
Durable Medical Equipment & Medical Supplies
PHY21926
CA
333600000X
Pharmacy
PHY21926
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY 21926
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396754891
NPI
—
01
—
AR 1471933
D E A LICENCE
—
05
—
PHA 219260
—
CA
01
—
PHY 21926
STATE PHARMACY LICENCE
CA
01
—
RPH 33277
STATE PHARMACIST LICENCE
CA
Enumeration date
08/05/2006
Last updated
05/25/2010
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