Provider Demographics
NPI:1407408065
Name:RENSCH, ANDREA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:RENSCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELPHI
Mailing Address - State:IN
Mailing Address - Zip Code:46923-1441
Mailing Address - Country:US
Mailing Address - Phone:765-564-4117
Mailing Address - Fax:765-564-3837
Practice Address - Street 1:1233 N STATE ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1056
Practice Address - Country:US
Practice Address - Phone:317-462-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-14
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26025563A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist