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General NPI Number Information
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NPI Number | 1265036529
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Entity Type | Individual
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Provider Name | GREGORY TRENT WERLINE RPH
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Gender | Male
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 3200 KEN BALE BLVD
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City | BOWLING GREEN
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State | KY
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Zip | 42103-6025
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Country | US
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Telephone | 270-781-7727
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Fax |
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Provider Business Mailing Address
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Address Line | 2149 DAVIDSON RD
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City | BURKESVILLE
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State | KY
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Zip | 42717-7810
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Country | US
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Telephone | 859-539-7820
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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 | 011110
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License Number State | KY
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