Provider Demographics
NPI:1447014873
Name:RENDINE, GREGGORY (PHARMD)
Entity type:Individual
Prefix:
First Name:GREGGORY
Middle Name:
Last Name:RENDINE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SWEET ALLEN FARM RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-1451
Mailing Address - Country:US
Mailing Address - Phone:401-218-9888
Mailing Address - Fax:
Practice Address - Street 1:4927 HOMEVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2956
Practice Address - Country:US
Practice Address - Phone:412-469-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist