Healthcare Provider Details

I. General information

NPI: 1831477082
Provider Name (Legal Business Name): ANGELO JOHN GRECO PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 ENVIRON WAY
CHAPEL HILL NC
27517-4418
US

IV. Provider business mailing address

1106 ENVIRON WAY
CHAPEL HILL NC
27517-4418
US

V. Phone/Fax

Practice location:
  • Phone: 919-918-7595
  • Fax:
Mailing address:
  • Phone: 919-918-7595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19211
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: