Provider Demographics
NPI:1477159564
Name:HUGHES, GREGORY LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:LEE
Last Name:HUGHES
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 1:12120 TUSCANY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64505-3802
Mailing Address - Country:US
Mailing Address - Phone:816-248-2694
Mailing Address - Fax:
Practice Address - Street 1:201 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3451
Practice Address - Country:US
Practice Address - Phone:816-232-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011023690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist