Provider Demographics
NPI:1184014714
Name:KEARLEY, GREGORY L (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:L
Last Name:KEARLEY
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 1:500 INVERNESS CORS
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3773
Mailing Address - Country:US
Mailing Address - Phone:205-991-0666
Mailing Address - Fax:205-991-2444
Practice Address - Street 1:500 INVERNESS CORS
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-3773
Practice Address - Country:US
Practice Address - Phone:205-991-0666
Practice Address - Fax:205-991-2444
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9529OtherSTATE LICENSE