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General NPI Number Information
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NPI Number | 1710525654
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Entity Type | Individual
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Provider Name | GREGORY LOUIS SUHRHEINRICH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 4423 SOUTHWEST BLVD
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City | TULSA
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State | OK
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Zip | 74107-6472
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Country | US
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Telephone | 918-446-3541
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Fax |
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Provider Business Mailing Address
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Address Line | 211 S GREENWOOD AVE APT 116
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City | TULSA
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State | OK
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Zip | 74120-1451
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Country | US
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Telephone | 417-489-3175
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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 | 18616
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License Number State | OK
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