Provider Demographics
NPI:1083359723
Name:SATROPLUS, GREGORY NATHANIEL
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:NATHANIEL
Last Name:SATROPLUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 ODDIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-7573
Mailing Address - Country:US
Mailing Address - Phone:775-762-7552
Mailing Address - Fax:
Practice Address - Street 1:2299 ODDIE BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-7573
Practice Address - Country:US
Practice Address - Phone:775-358-4721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist