Provider Demographics
NPI:1609586593
Name:GREUBER, AUSTIN JAMES (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAMES
Last Name:GREUBER
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 MONROE ST APT 140
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1449
Mailing Address - Country:US
Mailing Address - Phone:734-756-5184
Mailing Address - Fax:
Practice Address - Street 1:9701 BELLEVILLE RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-1305
Practice Address - Country:US
Practice Address - Phone:734-699-0410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist