Provider Demographics
NPI:1710525654
Name:SUHRHEINRICH, GREGORY LOUIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LOUIS
Last Name:SUHRHEINRICH
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 1:211 S GREENWOOD AVE APT 116
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-1451
Mailing Address - Country:US
Mailing Address - Phone:417-489-3175
Mailing Address - Fax:
Practice Address - Street 1:4423 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-6472
Practice Address - Country:US
Practice Address - Phone:918-446-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist