RENES DRUG STORE INC NPI 1114095320

NPI Information

  • NPI: 1114095320
  • Provider Name: RENES DRUG STORE INC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 201 WEST MAIN CROSS
    TAYLORVILLE, IL
    ZIP 62568
  • Phone: (217) 824-3533

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NPI Details

RENES DRUG STORE INC is a pharmacy in Taylorville, IL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. RENES DRUG STORE INC NPI is 1114095320. The provider is registered as an organization entity type.

The provider's business location address is:

201 WEST MAIN CROSS
TAYLORVILLE, IL
ZIP 62568-247
Phone: (217) 824-3533
Fax: (217) 824-3492

The provider's authorized official is Gordon John Mazzotti .
The authorized official title is President Chief Executive Officer and has the following contact phone number (217) 824-3533.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 12/14/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacy054005099ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========6256801MEDICAIDILLINOIS
20300520001MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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