Provider Demographics
NPI:1407486319
Name:HYNES, GREG L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:L
Last Name:HYNES
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:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-1599
Mailing Address - Country:US
Mailing Address - Phone:308-237-2178
Mailing Address - Fax:308-237-0287
Practice Address - Street 1:2123 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5303
Practice Address - Country:US
Practice Address - Phone:308-237-2178
Practice Address - Fax:308-237-0287
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist