Doctor Name: | RENEE MARIE JORGENSEN |
NPI Number: | 1699871285 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPHT |
License Number: | 0501-0110-8473-164 |
Business Practice Address: | 8744 Ferry St Montague, MI - 494371391 |
Business Phone Number: | 2318938255 |
Business Fax Number: | |
Mailing Address: | 8744 Ferry St, MONTAGUE |
State: | MI |
Postal Code: | 494371391 |
Phone Number: | 2318938255 |
Fax Number: | |
NPI Enumeration Date: | 09/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | 0501-0110-8473-164 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |