Provider Demographics
NPI:1154680262
Name:GROGAN, LARRY JOSEPH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:JOSEPH
Last Name:GROGAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 CREPE MYRTLE DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7402
Mailing Address - Country:US
Mailing Address - Phone:864-331-9603
Mailing Address - Fax:
Practice Address - Street 1:398 CREPE MYRTLE DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-7402
Practice Address - Country:US
Practice Address - Phone:864-331-9603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC50981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist