Healthcare Provider Details

I. General information

NPI: 1740104199
Provider Name (Legal Business Name): LONDON GREGORY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SW GAGE BLVD
TOPEKA KS
66604-1700
US

IV. Provider business mailing address

1001 SW GAGE BLVD
TOPEKA KS
66604-1700
US

V. Phone/Fax

Practice location:
  • Phone: 785-272-3015
  • Fax: 785-272-4015
Mailing address:
  • Phone: 785-272-3015
  • Fax: 785-272-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-113725
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: