Provider Demographics
NPI:1053602409
Name:JOHNS, GREGORY W (RPH)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:W
Last Name:JOHNS
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 1:80 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:MA
Mailing Address - Zip Code:01238-9417
Mailing Address - Country:US
Mailing Address - Phone:413-243-3215
Mailing Address - Fax:
Practice Address - Street 1:197 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1602
Practice Address - Country:US
Practice Address - Phone:413-528-2424
Practice Address - Fax:413-528-5605
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist