Renu Johnson
Pharmacist in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1760140503
StatusActive
Last updated in NPPESNov 29, 2021
Details
- NPI
- 1760140503
- Entity type
- Individual (NPI-1)
- Name
- Renu Johnson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 29, 2021
- Certification date
- Nov 15, 2021
- Last updated
- Nov 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 26028520A | IN | Yes |
Practice location
5311 Coldwater RdFort Wayne, IN 46825-5444
Phone 260-484-4528
Mailing address
11008 Millwood CtFort Wayne, IN 46845-6153
Phone 520-490-9347
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