Provider Demographics
NPI:1982130423
Name:LUNSON, GREG M
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:M
Last Name:LUNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 REEDER ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1554
Mailing Address - Country:US
Mailing Address - Phone:913-492-0359
Mailing Address - Fax:800-545-8458
Practice Address - Street 1:8030 REEDER ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1554
Practice Address - Country:US
Practice Address - Phone:913-492-0359
Practice Address - Fax:800-545-8458
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-128331835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist