Provider Demographics
NPI:1912031402
Name:MARTIN, RENEE CHRISTINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:CHRISTINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 N HIGHLAND PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2016
Mailing Address - Country:US
Mailing Address - Phone:423-209-6004
Mailing Address - Fax:
Practice Address - Street 1:455 N HIGHLAND PARK AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2016
Practice Address - Country:US
Practice Address - Phone:423-209-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist