Provider Demographics
NPI:1811025984
Name:GREAR, CYNTHIA JOAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JOAN
Last Name:GREAR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401
Mailing Address - Country:US
Mailing Address - Phone:712-792-1051
Mailing Address - Fax:
Practice Address - Street 1:121 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:IA
Practice Address - Zip Code:51449
Practice Address - Country:US
Practice Address - Phone:712-464-3165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist