Provider Demographics
NPI:1033419080
Name:DIEHL, GREGORY (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:DIEHL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 MEETINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE GLEN
Mailing Address - State:PA
Mailing Address - Zip Code:19002-4024
Mailing Address - Country:US
Mailing Address - Phone:215-643-2880
Mailing Address - Fax:215-643-7544
Practice Address - Street 1:1925 NORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:MAPLE GLEN
Practice Address - State:PA
Practice Address - Zip Code:19002-2921
Practice Address - Country:US
Practice Address - Phone:215-643-2880
Practice Address - Fax:215-643-7544
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030578L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP030578LOtherPHARMACIST LICENSE