Provider Demographics
NPI:1740588979
Name:OUTSLAY, GREGOR ALLEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGOR
Middle Name:ALLEN
Last Name:OUTSLAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CARVER ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733-1103
Mailing Address - Country:US
Mailing Address - Phone:802-247-8050
Mailing Address - Fax:
Practice Address - Street 1:1 CARVER ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:VT
Practice Address - Zip Code:05733-1103
Practice Address - Country:US
Practice Address - Phone:802-247-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-12
Last Update Date:2011-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0003386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist