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General NPI Number Information
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NPI Number | 1750948543
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Entity Type | Individual
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Provider Name | CATHY GRIERSON
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Gender | Female
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 134 W MORTON AVE
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City | JACKSONVILLE
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State | IL
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Zip | 62650-2811
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Country | US
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Telephone | 217-243-7818
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 FOREST AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-3504
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Country | US
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Telephone | 614-370-8192
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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 | 2014024728
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03331384
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051299624
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License Number State | IL
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