Provider Demographics
NPI:1851944854
Name:GREGGI, JUSTIN ANTHONY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ANTHONY
Last Name:GREGGI
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 1:1412 MOSS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714-8306
Mailing Address - Country:US
Mailing Address - Phone:814-421-9502
Mailing Address - Fax:
Practice Address - Street 1:4606 ADMIRAL PEARY HWY
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4203
Practice Address - Country:US
Practice Address - Phone:814-472-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI013114OtherPENNSYLVANIA BOARD OF PHARMACY
PARP453551OtherPENNSYLVANIA BOARD OF PHARMACY