Provider Demographics
NPI:1922048081
Name:KRIVEC, GREG (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:
Last Name:KRIVEC
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:GREG
Other - Middle Name:
Other - Last Name:KRIVEC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:19044 E LOW DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3190
Mailing Address - Country:US
Mailing Address - Phone:303-693-4227
Mailing Address - Fax:720-535-6996
Practice Address - Street 1:19044 E LOW DR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3190
Practice Address - Country:US
Practice Address - Phone:303-693-4227
Practice Address - Fax:720-535-6996
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist