Provider Demographics
NPI:1699377325
Name:HILL, RENARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RENARD
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39272-4486
Mailing Address - Country:US
Mailing Address - Phone:504-616-0620
Mailing Address - Fax:601-398-1184
Practice Address - Street 1:950 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5203
Practice Address - Country:US
Practice Address - Phone:601-924-8778
Practice Address - Fax:601-924-2797
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.017413183500000X
MST-09957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist