Provider Demographics
NPI:1861120883
Name:QUINNEY, RENEISHA MARIE (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:RENEISHA
Middle Name:MARIE
Last Name:QUINNEY
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45410-3027
Mailing Address - Country:US
Mailing Address - Phone:937-256-3111
Mailing Address - Fax:
Practice Address - Street 1:2916 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-3027
Practice Address - Country:US
Practice Address - Phone:937-256-3111
Practice Address - Fax:937-256-3541
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1710I1003X, 183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians