Provider Demographics
NPI:1396194783
Name:GROVER, JOHN CLAYTON JR (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CLAYTON
Last Name:GROVER
Suffix:JR
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 1:16 ASH BROOK RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-5918
Mailing Address - Country:US
Mailing Address - Phone:603-352-2469
Mailing Address - Fax:603-352-2592
Practice Address - Street 1:16 ASH BROOK RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-5918
Practice Address - Country:US
Practice Address - Phone:603-352-2469
Practice Address - Fax:603-352-2592
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist