Provider Demographics
NPI:1427418698
Name:GRIMES, LAUREN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:GRIMES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:839 KNICKERBOCKER RD
Mailing Address - Street 2:
Mailing Address - City:SCHAGHTICOKE
Mailing Address - State:NY
Mailing Address - Zip Code:12154-3626
Mailing Address - Country:US
Mailing Address - Phone:518-321-7341
Mailing Address - Fax:
Practice Address - Street 1:100 TECHNOLOGY CENTER DR
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4710
Practice Address - Country:US
Practice Address - Phone:781-566-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0096615183500000X
MAPH234793183500000X
NH3931183500000X
NY059034183500000X
COPHA.0023091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist