Individual provider Active NPI

Eugene W Gresh Jr., R.PH.

  • Pharmacist
  • Vernon, CT
National Provider Identifier
1326403262
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5657 Issued in CT
Practice address
520 Hartford Tpke
Unit D
Vernon, CT 06066-5037
Phone
(860) 979-0089
Fax
(860) 979-0091
NPI assigned
Dec 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5657 CT Primary

Addresses

Primary practice location

520 Hartford Tpke
Unit D
Vernon, CT 06066-5037

Mailing address

520 Hartford Tpke
Unit D
Vernon, CT 06066-5037
Phone (860) 979-0089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5657CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Health Compounding Pharmcacy Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1326403262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 HARTFORD TPKE",
            "address_2": "UNIT D",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665037",
            "telephone_number": "860-979-0089",
            "fax_number": "860-979-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 HARTFORD TPKE",
            "address_2": "UNIT D",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665037",
            "telephone_number": "860-979-0089",
            "fax_number": "860-979-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESH",
        "first_name": "EUGENE",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "5657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.