Nicholas Marks Grunewald, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD14167 Issued in AR

Practice address

325 MDG, 340 Magnolia Circle
Tyndall Afb, FL 32403

Phone

(850) 283-7377

NPI assigned

Mar 19, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1366901191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MDG/SGAP",
            "address_2": "340 MAGNOLIA CIR.",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "850-283-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MDG, 340 MAGNOLIA CIRCLE",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "850-283-7377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Congressional Cir",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722102832",
            "country_code": "US",
            "telephone_number": "501-690-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUNEWALD",
        "first_name": "NICHOLAS",
        "middle_name": "MARKS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD14167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mordecai Christopher Garcia
• Michelle Gautreaux, RDN/LDN
• Pamela Suzanne Gilley, LCSW
• Dominique D. Gougis, PSY.D.
• Jimbell Gray, IDMT
• Thomas Haney, IDMT
• Mark Lee Harris II, DDS
• Teresa Harroun, RN
• John Randall Heil, M.D.
• Matthew Hetrick, IDMT

• Pharmacist in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.