Russell Krenek | Tyler, TX • PECOS Search

Russell Krenek

Pharmacist

Pharmacy Service Providers

5415 S Broadway Ave, Tyler, TX 75703-1397

PECOS Enrollment

Based on the most recent information from CMS, provider Russell Krenek does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1104155597
Provider Type
Individual
Full Name
Krenek, Russell
Gender
Male

Sole Proprietor
Yes
Enumeration Date
12/14/2009
Last Updated
12/14/2009

Contact Information

Practice Location

5415 S Broadway Ave, Tyler, TX 75703-1397

Unlisted Fax

Mailing Location

5415 S Broadway Ave, Tyler, TX 75703-1397

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License 37833 Texas