Provider Demographics
NPI:1821384306
Name:KRENTZ, KIMBERLY STARLING (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:STARLING
Last Name:KRENTZ
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 1:1204 SUNBURST DR
Mailing Address - Street 2:T0964
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-8202
Mailing Address - Country:US
Mailing Address - Phone:919-778-1521
Mailing Address - Fax:
Practice Address - Street 1:1204 SUNBURST DR
Practice Address - Street 2:T0964
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-8202
Practice Address - Country:US
Practice Address - Phone:919-778-1521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist