Active NPI
Mark G Renier, R.PH.
- Pharmacist
- Moline, IL
National Provider Identifier
1639449515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.289814
- Practice address
- 901 6TH Street Dr
Moline, IL 61265-1291 - Phone
- (309) 799-3036
- NPI assigned
- Jan 9, 2012
- Last updated
- Jan 9, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16089 | IA | |
| Pharmacist | 183500000X | 051.289814 | IL | Primary |
Addresses
Primary practice location
901 6TH Street Dr
Moline, IL 61265-1291
Mailing address
901 6TH Street Dr
Moline, IL 61265-1291
Phone (309) 799-3036
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16089 | IA | MD | Addiction (Substance Use Disorder) Counselor |
| 051.289814 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326067200000",
"number": "1639449515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 6TH STREET DR",
"city": "MOLINE",
"state": "IL",
"postal_code": "612651291",
"telephone_number": "309-799-3036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 6TH STREET DR",
"city": "MOLINE",
"state": "IL",
"postal_code": "612651291",
"telephone_number": "309-799-3036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENIER",
"first_name": "MARK",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-09",
"last_updated": "2012-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "16089",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.289814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.