MEDICARE: MR. GREGORY BRIGGS RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26021259A	IN

General Provider Information

NPI Number	:	1821833419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY BRIGGS RPH

Provider Business Mailing Address
First Line	:	8751 MORRISON ST
Second Line	:
City	:	FORTVILLE
State	:	IN
Zip	:	46040-4014
Country	:	US
Telephone Number	:	317-840-7412
Fax Number	:

Provider Business Practice Location Address
First Line	:	5981 W BROADWAY
Second Line	:
City	:	MCCORDSVILLE
State	:	IN
Zip	:	46055-9355
Country	:	US
Telephone Number	:	317-335-3380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2024
Last Update Date	:	06/26/2024

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