Organization
RENAISSANCE FAMILY PHARMACY INC
Active
Other names
RENAISSANCE FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMEY KASHUBA (OWNER)
(302) 798-4801
Entity
Organization
Contact information
Practice address
2618 PHILADELPHIA PIKE, CLAYMONT, DE 19703-2504
(302) 798-4801
(302) 798-4804
Mailing address
2618 PHILADELPHIA PIKE, CLAYMONT, DE 19703-2504
(302) 798-4801
(302) 798-4804
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
A30000897
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0844919
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/26/2008
Last updated
01/08/2010
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