Provider Demographics
NPI:1346521226
Name:GRUNER, ANDREW SCOTT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOTT
Last Name:GRUNER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7744 HYTHE CIR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-8711
Mailing Address - Country:US
Mailing Address - Phone:419-307-4810
Mailing Address - Fax:
Practice Address - Street 1:1402 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3802
Practice Address - Country:US
Practice Address - Phone:937-291-2741
Practice Address - Fax:937-291-2840
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist