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General NPI Number Information
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NPI Number | 1396949558
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Entity Type | Organization
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Legal Business Name | GREENVILLE PHARMACY INC.
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 530 S BROADWAY ST
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City | GREENVILLE
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State | OH
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Zip | 45331-1927
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Country | US
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Telephone | 937-548-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 530 S BROADWAY ST
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City | GREENVILLE
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State | OH
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Zip | 45331-1927
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Country | US
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Telephone | 937-548-2424
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. STEPHEN PAUL BONFIGLIO
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Credential |
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Telephone | 937-548-4515
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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 | 02063330005585
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License Number State | OH
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