Organization
RENEES SURVIVOR SHOP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE MICHELE SCHICK (OWNER)
(419) 471-0603
Entity
Organization
Contact information
Practice address
5401 SECOR RD, TOLEDO, OH 43623-1930
(419) 471-0603
(419) 471-0090
Mailing address
5401 SECOR RD, TOLEDO, OH 43623-1930
(419) 471-0603
(419) 471-0090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000336645
ANTHEM
OH
01
—
04564
PARAMOUNT
OH
01
—
110284
PPOM
OH
01
—
7434617
AETNA
OH
05
—
874675764
—
MI
Enumeration date
07/07/2005
Last updated
12/07/2010
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