Provider Demographics
NPI:1518341775
Name:LEWIS, GREGORY EDWARD (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:EDWARD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225R KING ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2361
Mailing Address - Country:US
Mailing Address - Phone:413-587-2802
Mailing Address - Fax:
Practice Address - Street 1:225R KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2361
Practice Address - Country:US
Practice Address - Phone:413-587-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236018183500000X
VT033.0112591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist