Provider Demographics
NPI:1811270598
Name:GIRARD, GREGORY M (RPH)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:M
Last Name:GIRARD
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 1:19 SHAW DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6050
Mailing Address - Country:US
Mailing Address - Phone:603-472-8505
Mailing Address - Fax:603-472-8505
Practice Address - Street 1:283 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2937
Practice Address - Country:US
Practice Address - Phone:603-886-6124
Practice Address - Fax:603-889-6164
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist