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General NPI Number Information
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NPI Number | 1205057270
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Entity Type | Individual
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Provider Name | GREGORY SCHUTRUM RPH
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/08/2019
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Provider Practice Location Address
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Address Line | 209 MOUNT ZOAR ST
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City | ELMIRA
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State | NY
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Zip | 14904-1231
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Country | US
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Telephone | 607-733-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 COUNTY ROUTE 64
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City | HORSEHEADS
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State | NY
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Zip | 14845-2297
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Country | US
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Telephone | 607-739-2087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 039592
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License Number State | NY
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