Provider Demographics
NPI:1922601129
Name:RENTZ, MAUREEN L (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:L
Last Name:RENTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:L
Other - Last Name:MADSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3595 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3152
Mailing Address - Country:US
Mailing Address - Phone:706-549-8985
Mailing Address - Fax:
Practice Address - Street 1:3595 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3152
Practice Address - Country:US
Practice Address - Phone:706-549-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH-0298111835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist