Provider Demographics
NPI:1043747199
Name:RENNER, ERIN DOYLE (RPH)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:DOYLE
Last Name:RENNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4967 HEATH GATE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9449
Mailing Address - Country:US
Mailing Address - Phone:740-607-1376
Mailing Address - Fax:
Practice Address - Street 1:7000 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1519
Practice Address - Country:US
Practice Address - Phone:614-575-3741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-20
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-17785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist