Gareth Erwin Gridley, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

8154-40 Issued in WI

Practice address

808 S Duluth Ave
Sturgeon Bay, WI 54235-3807

Phone

(920) 746-5425

NPI assigned

Nov 22, 2011

Sex

Male

Sole proprietor

No

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

Registered Pharmacist

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1386911063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S DULUTH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353807",
            "telephone_number": "920-746-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S DULUTH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353807",
            "telephone_number": "920-746-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDLEY",
        "first_name": "GARETH",
        "middle_name": "ERWIN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "8154-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Angela Gorin, DPT
• Gary A Grahl, LPC
• Paul N Greenlaw, M.D.
• Derek Grenfell, D.C.
• Gina Rae Grenfell, D.D.S.
• Kathryn C Groff, LMFT-IT
• Carl D Grota, PT
• Michael Whitney Grota, PHARMD
• Carol Gale Halvorson, L.P.N.
• Megan Kristine Hannasch

• Pharmacist in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.