Active NPI
Marshall Tyler Renna, PHARMD
- Pharmacotherapy Pharmacist
- Tucson, AZ
National Provider Identifier
1063999779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- S023343
- Practice address
- 3601 S 6TH Ave
Tucson, AZ 85723-0001 - Phone
- (520) 792-1450
- NPI assigned
- Jul 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | S023343 | AZ | Primary |
Addresses
Primary practice location
3601 S 6TH Ave
Tucson, AZ 85723-0001
Mailing address
2302 E Fort Lowell Rd Apt 2240
Tucson, AZ 85719-2463
Phone (480) 748-1606
Other practice location 1
1919 N Dobson Rd
Chandler, AZ 85224-2237
Phone (480) 899-6713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S023343 | AZ | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1063999779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 E FORT LOWELL RD APT 2240",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857192463",
"telephone_number": "480-748-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 S 6TH AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857230001",
"telephone_number": "520-792-1450"
}
],
"practiceLocations": [
{
"address_1": "1919 N Dobson Rd",
"address_purpose": "LOCATION",
"city": "Chandler",
"state": "AZ",
"postal_code": "852242237",
"country_code": "US",
"telephone_number": "480-899-6713",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RENNA",
"first_name": "MARSHALL",
"middle_name": "TYLER",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-25",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "AZ",
"license": "S023343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.