Healthcare Provider Details

I. General information

NPI: 1851991103
Provider Name (Legal Business Name): STEWART CARL GRUEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 SMITH RD
NEWPORT RI
02841-1006
US

IV. Provider business mailing address

352 FOREST AVE
MIDDLETOWN RI
02842-4639
US

V. Phone/Fax

Practice location:
  • Phone: 401-841-6301
  • Fax:
Mailing address:
  • Phone: 440-812-1642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03136255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: