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General NPI Number Information
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NPI Number | 1457547044
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Entity Type | Organization
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Legal Business Name | GKB INC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 418 EAST MAIN ST
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City | JEFFERSON
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State | NC
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Zip | 28640
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Country | US
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Telephone | 336-246-9492
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Fax | 336-846-6680
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Provider Business Mailing Address
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Address Line | PO BOX 155
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City | JEFFERSON
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State | NC
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Zip | 28640
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Country | US
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Telephone | 336-246-9492
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Fax | 336-846-6680
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Authorized Official
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Title or Position | RPH OWNER
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Name | MR. GREG K BOWER
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Credential | RPH
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Telephone | 336-246-9492
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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 | 06110
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License Number State | NC
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