Provider Demographics
NPI:1770944936
Name:SEGNER, GREG A (RPH)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:A
Last Name:SEGNER
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 1:1951 S KEIM ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-8614
Mailing Address - Country:US
Mailing Address - Phone:610-469-8488
Mailing Address - Fax:
Practice Address - Street 1:377 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2309
Practice Address - Country:US
Practice Address - Phone:215-256-4146
Practice Address - Fax:215-256-0439
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035128L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012631040001Medicaid