Provider Demographics
NPI:1073781753
Name:REDNERS MARKETS INC
Entity Type:Organization
Organization Name:REDNERS MARKETS INC
Other - Org Name:REDNERS PHARMACY #35
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY CONTRACT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRETSCHMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-838-7694
Mailing Address - Street 1:2126 N FOUNTAIN GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-1414
Mailing Address - Country:US
Mailing Address - Phone:410-838-7694
Mailing Address - Fax:410-838-7564
Practice Address - Street 1:2126 N FOUNTAIN GREEN RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1414
Practice Address - Country:US
Practice Address - Phone:410-838-7694
Practice Address - Fax:410-838-7564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP047563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134017OtherOTHER ID NUMBER
MD0997350006Medicare NSC