Provider Demographics
NPI:1942509146
Name:GERY, GRACE C (RPH)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:C
Last Name:GERY
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 1:2796 MERIDIAN DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6071
Mailing Address - Country:US
Mailing Address - Phone:989-390-8994
Mailing Address - Fax:
Practice Address - Street 1:2438 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7210
Practice Address - Country:US
Practice Address - Phone:252-758-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032274183500000X
NC25449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist