OrganizationActive
Renes Drug Store Inc
NPI 1114095320 · Pharmacy · Taylorville, IL
Provider details
- NPI number
- 1114095320
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Gordon Mazzotti, President Chief Executive Officer(217) 824-3533
- License
- 054005099 (IL)
Specialties & taxonomies
Suppliers
Practice location
201 West Main Cross
Taylorville, IL 62568-2247
Phone: (217) 824-3533
Fax: (217) 824-3492
Approximate (ZIP-level) locationGet directions
Mailing address
201 West Main Cross
Taylorville, IL 62568-2247
Registry dates
- Enumerated
- 2006-12-04
- Last updated
- 2010-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.