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Contact Information

RENEGADE PHARMACY INC.
RT 10 COOK PARKWAY/18 LOGAN STREET
OCEANA, WV24870
 Phone: 304-682-0444
 Fax: 304-682-0447
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for RENEGADE PHARMACY INC.

NPI Number 1154977023
LBN Legal business name RENEGADE PHARMACY INC.
Authorized official JENNY CUNNINGHAM - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/15/2019
Last updated 08/15/2019 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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