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General NPI Number Information
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NPI Number | 1205105566
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Entity Type | Individual
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Provider Name | JOSEPN ALLEN GREINER R.PH.
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Gender | Male
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 5510 HOWARD ST RPH ON THE GO USA
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City | SKOKIE
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State | IL
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Zip | 60077-2620
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Country | US
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Telephone | 847-779-6162
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Fax |
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Provider Business Mailing Address
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Address Line | 19645 DOGWOOD DR
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City | NEW BUFFALO
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State | MI
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Zip | 49117-8949
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Country | US
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Telephone | 269-469-4585
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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 | 5302022468
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 26091706A
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License Number State | IN
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