| Renue RX #4 | |
|
201 Commerce St Fort Worth TX 76102-7206 | |
| (682) 285-1100 | |
| (682) 285-1103 |
| Full Name | Renue RX #4 |
|---|---|
| Speciality | Pharmacy |
| Location | 201 Commerce St, Fort Worth, Texas |
| Authorized Official Name and Position | Raj Milan Chhadua (OWNER) |
| Authorized Official Contact | 2144222598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renue RX #4 Po Box 2735 Frisco TX 75034-0051 | Renue RX #4 201 Commerce St Fort Worth TX 76102-7206 Ph: (682) 285-1100 |
| NPI Number | 1225510795 |
|---|---|
| Provider Enumeration Date | 08/31/2018 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 0547593477 |
|---|---|
| Medicare Enrollment ID | O20200506000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225510795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Secondary |
| 3336C0003X | Pharmacy - Community/retail Pharmacy | (NU) | Primary |
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