Renegar Drug Store

Primary specialty

PharmacistTaxonomy code 183500000X

License

3868 Issued in TN

Legal business name

RENEGAR DRUG STORE

Practice address

629 N Main St
Shelbyville, TN 37160-3235

Phone

(931) 684-1933

Fax

(931) 684-8739

NPI assigned

Jun 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barry Childers, D.P.H.

Title

Owner/Pharmacist

Phone

(931) 684-1933

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144256538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 N MAIN ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603235",
            "telephone_number": "931-684-1933",
            "fax_number": "931-684-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N MAIN ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603235",
            "telephone_number": "931-684-1933",
            "fax_number": "931-684-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEGAR DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "931-684-1933",
        "authorized_official_credential": "D.P.H."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "3868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3544640",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.