RENEGADE PHARMACY INC.
NPI 1154977023
Pharmacy - Community/Retail Pharmacy in Oceana, WV

Q: What is Renegade Pharmacy Inc.'s NPI number?

The NPI number for Renegade Pharmacy Inc. is 1154977023. It was assigned to this organization in the NPPES registry on August 15, 2019.

Q: What is Renegade Pharmacy Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since August 15, 2019CLIA 51D2326037 · Waiver

RT 10 COOK PARKWAY/18 LOGAN STREET, OCEANA, WV 24870(304) 682-0444(304) 682-0447 Get Directions Write a Review

NPPES record last updated: August 15, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Renegade Pharmacy Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENEGADE PHARMACY INC. (NPI 1154977023) is a healthcare organization registered as a community/retail pharmacy in Oceana, West Virginia and active in the NPI registry since August 2019. The organization holds a CLIA Waiver certificate valid through June 24, 2027 and lists Jenny Lee Cunningham, Owner, as its authorized official.

NPPES Registry Identity

NPI1154977023

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameRENEGADE PHARMACY INC.

Location AddressRT 10 COOK PARKWAY/18 LOGAN STREETOceana, WV 24870

Mailing AddressPo Box 69Oceana, WV 24870-0069 · (304) 682-0444 · Fax (304) 682-0447

Phone(304) 682-0444

Fax(304) 682-0447

Organization SubpartNo

Authorized OfficialJenny Lee CunninghamOwner · (304) 994-0635

Enumeration DateAugust 15, 2019

✔ NPI 1154977023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

RT 10 COOK PARKWAY/18 LOGAN STREET, Oceana, WV 24870

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D2326037

Renegade Pharmacy, Inc · Oceana, WV

Active · expires Jun 24, 2027

CLIA Number51D2326037

Laboratory TypePharmacy

Certificate Effective DateJune 25, 2025

Certificate Expiration DateJune 24, 2027

Laboratory DirectorDevonna Miller-West

Laboratory Phone(304) 682-0444

Laboratory LocationRenegade Pharmacy, Inc18 Logan Street, Oceana, WV 24870

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Renegade Pharmacy Inc carries, from the Medicare DMEPOS supplier directory.

Renegade Pharmacy Inc

DMEPOS supplier · Oceana, WV

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Does not accept Medicare assignment

Renegade Pharmacy Inc has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20414783

Medicare Participant SinceMarch 30, 2020

Supplier Location18 Logan StOceana, WV 24870

Phone(304) 682-0444

Supplier Specialties

Pharmacy

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renegade Pharmacy Inc.'s NPI number?

The NPI number for Renegade Pharmacy Inc. is 1154977023. It was assigned to this organization in the NPPES registry on August 15, 2019.

Where is Renegade Pharmacy Inc. located?

Renegade Pharmacy Inc. is located at Rt 10 Cook Parkway/18 Logan Street, Oceana, WV 24870. The listed phone number is (304) 682-0444.

What is Renegade Pharmacy Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Renegade Pharmacy Inc. accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Renegade Pharmacy Inc does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Renegade Pharmacy Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D2326037) is associated with this NPI, valid through June 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Renegade Pharmacy Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Renegade Pharmacy Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Renegade Pharmacy Inc. was last updated on August 15, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.