Provider Demographics
NPI:1962792325
Name:ZRENCHAK, DOLORES ANN (RPH)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:ANN
Last Name:ZRENCHAK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6556 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057
Mailing Address - Country:US
Mailing Address - Phone:440-428-1128
Mailing Address - Fax:
Practice Address - Street 1:6556 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2552
Practice Address - Country:US
Practice Address - Phone:440-428-1128
Practice Address - Fax:440-428-0011
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03310732183500000X
PARP027830L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist