Healthcare Provider Details

I. General information

NPI: 1700161213
Provider Name (Legal Business Name): GREGORY EMMETT DREWRY PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2011
Last Update Date: 10/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2744 WASHINGTON RD
AUGUSTA GA
30909-2218
US

IV. Provider business mailing address

2744 WASHINGTON RD
AUGUSTA GA
30909-2218
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-4277
  • Fax: 706-733-1917
Mailing address:
  • Phone: 706-733-4277
  • Fax: 706-733-1917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH011385
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: